Circulating osteocalcin is associated with time in range and other metrics assessed by continuous glucose monitoring in type 2 diabetes

Jun Liu; Yinghua Wei; Pu Zang; Wei Wang; Zhouqin Feng; Yanyu Yuan; Hui Zhou; Zhen Zhang; Haiyan Lei; Xinyi Yang; Jun Liu; Bin Lu; Jiaqing Shao

doi:10.1186/s13098-022-00863-4

Circulating osteocalcin is associated with time in range and other metrics assessed by continuous glucose monitoring in type 2 diabetes

Diabetol Metab Syndr. 2022 Aug 4;14(1):109. doi: 10.1186/s13098-022-00863-4.

Authors

Jun Liu^#¹, Yinghua Wei^#², Pu Zang^#², Wei Wang², Zhouqin Feng¹, Yanyu Yuan³, Hui Zhou¹, Zhen Zhang¹, Haiyan Lei¹, Xinyi Yang², Jun Liu³, Bin Lu⁴, Jiaqing Shao⁵

Affiliations

¹ Department of Endocrinology, Jinling Hospital, Southern Medical University, Nanjing, China.
² Department of Endocrinology, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China.
³ Department of Endocrinology, Jinling Hospital, Nanjing Medical University, Nanjing, China.
⁴ Department of Endocrinology, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China. yearinyearout@126.com.
⁵ Department of Endocrinology, Jinling Hospital, Southern Medical University, Nanjing, China. shaojiaqing@nju.edu.cn.

^# Contributed equally.

Abstract

Background: Osteocalcin, a protein secreted mainly by mature osteoblasts, has been shown to be involved in glucose metabolism through various pathways. However, few studies has explored the association between osteocalcin and Time in range (TIR). Continuous glucose monitoring (CGM) -derived metrics, such as TIR and other indexes have been gradually and widely used in clinical practice to assess glucose fluctuations. The main purpose of this study was to investigate the correlation between osteocalcin and indexes from CGM in patients with type 2 diabetes mellitus (T2DM).

Method: The total number of 376 patients with T2D were enrolled, all of them performed three consecutive days of monitoring. They were divided into four groups on account of the quartile of osteocalcin. Time in range, Time below range (TBR), Time above range(TAR) and measures of glycemic variability (GV) were assessed for analysing. After a 100 g standard steamed bread meal, blood glucose (Glu0h Glu0.5 h, Glu1h, Glu2h, GLu3h), C-peptide (Cp0h, Cp0.5 h, Cp1h, Cp2h, Cp3h), serum insulin (INS0h, INS0.5 h, INS1h, INS2h, INS3h) concentrations at different time points were obtained. HOMA-IS, HOMA-βwas calculated to evaluate insulin sensitivity and insulin secreting of the participants.

Results: Patients with higher osteocalcin level had higher TIR (P < 0.05). Spearman correlation analysis showed that osteocalcin was positively correlated with TBR (although the P value for TBR was greater than 0.05) (r = 0.227, P < 0.001 r = 0.068, P = 0.189) and negatively correlated with TAR (- 0.229, P < 0.001). Similarly, there was a negative correlation between osteocalcin and glycemic variability (GV) indicators, including SD, MBG, MODD, ADDR, and MAGE (P value of MAGE > 0.05). Multiple stepwise regression showed that osteocalcin was an independent contributor to TIR, TAR and HOMA-IS.

Conclusion: Circulating osteocalcin is positively correlated with TIR and negatively correlated with MODD, ADDR, and MAGE. Osteocalcin may have a beneficial impact on glucose homeostasis in T2DM patients.

Keywords: Glycemic control; HOMA-IS; Osteocalcin; Time in range; Type 2 diabetes.

Abstract

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