Metabolic and bone profile in postmenopausal women with and without type 2 diabetes: a cross-sectional study

Rom J Intern Med. 2019 Mar 1;57(1):61-67. doi: 10.2478/rjim-2018-0036.

Abstract

Introduction: Current studies support the implication of metabolic changes associated with type 2 diabetes in altering bone metabolism, structure and resistance.

Objective: We conducted a cross-sectional study on postmenopausal women aimed to analyze the differences in metabolic and bone profile in patients with and without type 2 diabetes Methods. We analyzed the metabolic and bone profile in postmenopausal women with and without type 2 diabetes (T2DM). Clinical, metabolic, hormonal parameters, along with lumbar, hip and femoral bone mineral density (BMD) and trabecular bone score (TBS) were evaluated.

Results: 56 women with T2DM(63.57±8.97 years) and 83 non-T2DM (60.21±8.77 years) were included. T2DM patients presented a higher value of body mass index (BMI) and BMD vs. control group (p = 0.001; p = 0.03-lumbar level, p = 0.07-femoral neck and p = 0.001-total hip). Also, BMI correlated positively with lumbar-BMD and glycated hemoglobin (HbA1c) (r = 0.348, p = 0.01; r = 0.269, p = 0.04), correlation maintained even after age and estimated glomerular filtration rate (eGFR) adjustment (r = 0.383, p = 0.005; r = 0.237, p = 0.08). Diabetic patients recorded lower levels of 25(OH)D(p = 0.05), bone markers (p ≤ 0.05) and TBS(p = 0.07). For the entire patient group we found a negative correlation between HbA1c level and bone markers: r = -0.358, p = 0.0005-osteocalcin, r = -0.40, p = 0.0005-P1NP, r = -0.258, p = 0.005-crosslaps.

Conclusions: Our results indicate the presence of altered bone microarchitecture in T2DZ patients according to the TBS score, combined with lower levels of bone markers, with a statistically significant negative correlation between HbA1c level and bone markers.

Keywords: bone density; diabetic bone disease; osteocalcin; trabecular bone score; type 2 diabetes mellitus.

MeSH terms

  • 25-Hydroxyvitamin D 2 / metabolism
  • Aged
  • Biomarkers / metabolism
  • Body Mass Index
  • Bone Density*
  • Bone Resorption
  • Bone and Bones / metabolism*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Middle Aged
  • Obesity / metabolism
  • Osteocalcin / metabolism
  • Peptide Fragments / metabolism
  • Postmenopause / metabolism*
  • Procollagen / metabolism

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Peptide Fragments
  • Procollagen
  • hemoglobin A1c protein, human
  • procollagen Type I N-terminal peptide
  • Osteocalcin
  • 25-Hydroxyvitamin D 2