The state of bone metabolism in patients with type 2 diabetes mellitus
DOI:
https://doi.org/10.14739/2310-1237.2018.3.151855Keywords:
type 2 diabetes mellitus, bone metabolism, osteoporosisAbstract
The aim of this work is to investigate the state of bone metabolism status and its relationship with carbohydrate metabolism
in patients with type 2 diabetes.
Materials and methods. 94 patients were studied, among whom the 1 st group – 22 patients with osteoporosis (OP), the 2nd group – 22 patients with type 2 diabetes mellitus (DM), the 3rd group – 50 patients with combined course of these diseases. An ultrasound densitometry using the Omnisense 7000 ultrasound densitometer (BeamMed Ltd, Israel) was performed for all the
patients. The state of bone tissue was determined by criteria of the WHO. The levels of osteocalcin (OC), parathyroid hormone (PTH), calcitonin in blood serum, the level of deoxypyridinoline (DPD) were determined in morning urine for all patients. In patients with type 2 DM the levels of C-peptide, insulin, glucose, HbA1c and HOMA index were studied
Results. It was revealed that patients of the 3rd group had signifiant decrease in OC level by 44 %, DPD by 24 %, PHT by 28 % (P < 0.05) in comparison to the patients of the 1 st group. In 53 % of patients of the 3rd group the development of OP was characterized by decreased bone formation and increased bone resorption. The patients of the 3rd group had signifiantly
higher levels of Hb1c by 11.5 %, glucose by 25 %, HOMA index by 7.2 % (P < 0.05), while the level of OC and DPD were lower by 8.5 % and 17 %, (P < 0.05) respectively in comparison with patients of group 2. The levels of OC and DPD were signifiantly lower in patients with decompensation of type 2 diabetes, in comparison with compensated diabetes by -12 % and -17 %, respectively (P < 0.05). The level of HbA1c signifiantly inflences the state of bone metabolism. With an increase in HbA1c of more than 7.5 %, the level of OC decreases by 12 %, and DPD by 17 % (P < 0.05).
Conclusions. The results suggest that type 2 DM leads to slowdown of bone metabolism, as the 3rd group patients had signifiantly reduced levels of OK and DPD as compared to the patients of the 1 st group. Poor glycemic control can be one of the factors that reduce the level of bone markers.
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