Characteristics of Bone Metabolism in Postmenopausal Women With Newly Diagnosed Type 2 Diabetes Mellitus

Huijuan Li; Yuhua Wen; Peipei Liu; Liya Zhang; Xiaoya Zhang; Yichen Liu; Bin Ma; Haidong Kuang; Jianxin Wang; Lige Song

Disclosures

Clin Endocrinol. 2021;95(3):430-438. 

In This Article

Results

Clinical Characteristics of the Study Population

Patients with T2DM (DM group) had higher BMI comparing to non-DM group (24.71 ± 3.77 vs 23.21 ± 3.97kg/m2, P =.005). Moreover, age, status of current smoking and current drinking had no significant difference between two groups. Comparing to non-DM group, DM group had higher level of HbA1c (10.98 ± 2.48 vs 5.75 ± 0.35%, P <.001). The levels of Ca, corrected Ca and P showed no significant differences between two groups (Table 1).

When comparing the level of bone turnover markers between two groups, patients with T2DM had higher level of total ALP [97.00(85.50–122.50) vs 81.00(66.00–98.00)U/L, P <.001], BALP [18.00(14.85–24.83) vs 14.70(12.10–19.98)μg/L, P <.001] but lower level of P1NP [39.40(33.40–55.19) vs 54.10(41.40–66.70)ng/ml, P <.001] and OC [15.07(11.62–18.56) vs 20.87(15.78–26.71)ng/mL, P <.001]. The levels of TRACP-5b and CTX were not significantly different between two groups (Table 2). As for two important hormones regulating bone turnover, the level of PTH was lower in the DM group when comparing to the non-DM group [40.66(29.87–45.38) vs 45.04(37.00–58.54)pg/mL, P <.001], while the level of 25(OH) showed no difference between two groups (Table 2).

DXA results showed that patients with T2DM had higher BMD in lumbar 1–4 (0.87 ± 0.16 vs 0.77 ± 0.16g/cm2, P <.001), femur neck (0.66 ± 0.13 vs 0.60 ± 0.12g/cm2, P <.001) and total hip (0.82 ± 0.14 vs 0.73 ± 0.13g/cm2, P <.001) when comparing to the non-DM individuals. And the proportion of osteoporosis was lower in DM group (35.23% vs 59.21%, P <.001) (Table 2).

Correlations Between Bone Turnover Markers and its Related Hormones With Other Parameters in Both Groups

Pearson correlation analysis was used to analyse the relationships between age, BMI, current smoking, current drinking, lipid profile and HbA1c with bone turnover markers and its related hormones. Results in Table 3 showed that age was negatively correlated with the level of 25(OH) in DM group (r = −0.267, P =.012) but not in non-DM group. Current smoking was negatively correlated with BALP (r = −0.240, P =.024) and OC (r = −0.213, P =.046) in DM group but not in non-DM group. Current smoking (r = −0.176, P =.030) and current drinking (r= −0.294, P <.001) were negatively correlated with CTX in non-DM group but not in DM group. BMI was positively correlated with BALP (r = 0.216, P =.043) and PTH (r = 0.227, P =.033) and negatively correlated with TRACP-5b (r= −0.284, P =.007) in DM groups but not in non-DM groups; however, BMI was negatively correlated with P1NP (r = −0.171, P =.036) and OC (r = −0.230, P =.004) in non-DM groups but not in DM group (Table 3).

HbA1c was negatively correlated with P1NP (r = −0.370, P <.001) and OC (r = −0.362, P =.001), but positively correlated with TRACP-5b (r = 0.212, P =.048) in DM group. In non-DM group, HbA1c was also negatively correlated with BALP (r = −0.173, P =.033), P1NP (r = −0.177, P =.030) and OC (r = −0.252, P =.002) (Table 3).

Multiple Linear Regression Analysis of Bone Metabolism-related Markers and Other Clinical Parameters in Both Groups

Multiple linear regression analysis was conducted after adjusting age, BMI and other variables that indicated possible correlation with bone turnover markers (P <.1 in Table 3). The results in Table 4 showed that in patients with T2DM, HbA1c was negatively correlated with both P1NP (β= −0.059, P <.001) and OC (β= −0.057, P <.001) independently. In the non-DM group, HbA1c was negatively correlated with BALP (β= −0.241, P =.021) and OC independently (β= −0.219, P =.032). As for bone resorption markers, current smoking and current drinking were negatively correlated with CTX in the non-DM group (Table 4).

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