Significance of biochemical markers in diagnosis of bone remodeling disturbances among diabetic mellitus persons

Abstract

Aim. To assess the influence of changes, observed in men and women with type 1and 2 diabetes mellitus (DM1, DM2) on the state of bone metabolism markers; to determine the directions of changes in bone remodeling serum markers among patients of both genders, suffering from this disease.

Materials and methods. The cross-sectional study of patients, diagnosed DM1 (n = 98) and DM2 (n = 137) was conducted; the control group included 82 persons. In all patients, calciotropic hormones, the serum markers of bone remodeling, were studied.

Results. The obtained results, regarding assessment of bone metabolism markers content in blood of DM1 and DM2 patients compared to the control, indicated the presence of pathological changes in bone remodeling processes in the form of decrease in osteogenesis marker PINP for patients with DM1 by 16 %, DM 2 – by 12 %, compared with the control group, and increase in bone resorption marker b-CTx in 32 % of patients with DM1 and 25 % with DM2; inconsistency of changes in bone remodeling processes in DM1 patients, with preferential alterations of bone resorption indices, was determined in 28 % of cases. Patients with DM2 had lower PINP and b-CTx levels that reflects the lower bone tissue metabolism, compared to DM1 patients, irrespective of age and duration of disease.

Conclusions. The bone mass loss in the majority of the examined patients with diabetes is connected with suppression of osteogenesis and to a significantly lesser extent – with bone tissue resorption. Bone remodeling marker values in patients with DM2 are lower than with DM1. Such factors as glycemic profile compensation, duration of diabetes and presence of diabetic nephropathy are able to influence bone metabolism.

Keywords

diabetes mellitus / osteoporosis / mineral density of bone

References

[1] Fisher A., Srikusalanukul W, Fisher L., Smith P.N. Lower serum P1NP/βCTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults. Clin Interv Aging 2017; 12: 1131-1140.

[2] Hinton P.S. Role of reduced insulin-stimulated bone blood flow in the pathogenesis of metabolic insulin resistance and diabetic bone fragility. Medical Hypotheses 2016; 93: 81-86.

[3] Jiao H., Xiao E., Graves D.T. Diabetes and its effect on bone and fracture healing. Curr Osteoporos Rep 2015; 13(5): 327-335.

[4] Jørgensen H.S., Winther S., Bøttcher M., Hauge E., Rejnmark L., Svensson M., Ivarsen P. Bone turnover markers are associated with bone density, but not with fracture in end stage kidney disease: a cross-sectional study. BMC Nephrol 2017; 18: 284.

[5] Liamis G., Liberopoulos E., Barkas F., Elisaf M. Diabetes mellitus and electrolyte disorders. World J Clin Cases 2014; 16; 2(10): 488-496.

[6] Ling O., Rivadeneira F., Zillikens M.C., Oei E. Diabetes, diabetic complications, and fracture risk. Curr Osteoporos Rep 2015; 13 (2): 106-115.

[7] Nakashima A., Yokoyama K., Yokoo T., Urashima M. Role of vitamin D in diabetes mellitus and chronic kidney disease. World J Diabetes 2016; 10; 7(5): 89-100.

[8] Yamamoto M., Sugimoto T. Advanced glycation end products, diabetes, and bone strength. Curr Osteoporos Rep 2016; 14(6): 320-326.

RIGHTS & PERMISSIONS

Safarova S.S.