DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20203041

Study of bone turnover markers, procollagen type 1 N-terminal propeptide and osteocalcin in healthy and type 2 diabetes mellitus postmenopausal women

G. G. Kaushik, Rajesh Chahar, Subhash Chandra

Abstract


Background: Individuals with diabetes mellitus are at increased risk of metabolic bone disease due to decrease in bone strength and quality. Several bone turnover markers like serum procollagen type I N propeptide (P1NP) and serum osteocalcin are powerful tools for studying osteoporosis and fracture risk across population to provide diagnostic and prognostic information of bone health. The aim of this study was to recognize possible correlation of levels of serum P1NP and osteocalcin in type-2 diabetic (T2DM) postmenopausal women as compared to healthy postmenopausal women.

Methods: The study included 100 proven cases of type-2 diabetic postmenopausal women with age matched healthy postmenopausal women as controls. P1NP, osteocalcin, and other relevant parameters were measured. Differences between diabetics and controls were analyzed.

Results: The body mass index was higher in diabetic group as compared to controls. The HbA1c% was (6.94±1.43) in diabetic group and (5.57±1.21) in non-diabetics. Low serum level of 25 (OH) D was observed both in diabetic and non-diabetic groups but significantly lower in T2DM. Procollagen type 1 N propeptide was lower in diabetic group (37.59±17.20 ng/mL) as compared to non-diabetic (52.14±24.82 ng/mL). Osteocalcin was lower (15.64±8.06 ng/ml) as compared to non-diabetic group (21.85±9.12 ng/ml). Lower osteocalcin and P1NP levels found in this study suggests slower bone metabolism with reduced bone formation in postmenopausal diabetics.

Conclusions: Serum procollagen type 1 N propeptide and osteocalcin in postmenopausal diabetic women were lower as compared to non-diabetic group.


Keywords


Bone turnover markers, Osteocalcin, Procollagen type I N propeptide, Type-2 diabetes

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References


Endres DB, Rude RK. Mineral and bone metabolism. Burtis CA, Ashwood ER, Editors. Tietz Textbook of Clinical Chemistry. 3rd ed. Philadelphia: W.B. Saunders; 1998:1395-1414.

Garnero P, Delmas PD. New developments in biochemical markers for osteoporosis. Calcified Tissue Int. 1996;59 (Suppl 1):S2-S9.

Jian-min L, Clifford JJ, Patricia D, Stavroula K, Gerard K. Regulation of glucose handling by the skeleton: insights from mouse and human studies. Diabetes. 2016;65:3225-32.

Sanches CP, Vianna AGD, Barreto F, DE C. The impact of type 2 diabetes on bone metabolism. Diabetol Metabol Syndrome. 2017;9:85.

Martinez-Laguna D, Tebe C, Javaid MK, Nogues X, Arden NK, Cooper C, et al. Incident type 2 diabetes and hip fracture risk: a population-based matched cohort study. Osteoporos Int. 2015;26:827-33.

Vasikaran S, Eastell R, Bruyere O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011;22(2):391-420.

Risteli J, Risteli L. Products of bone collagen metabolism. In: Dynamics of bone and cartilage metabolism (MJ Seibel, SP Robins, JP Bilezikian, eds). Academic Press, San Diego; 1999:275-287.

Ferron M, Wei J, Yoshizawa T, Del Fattore A, De Pinho RA, Teti A, et al. Insulin signaling in osteoblasts integrates bone remodelling and energy metabolism. Cell. 2010;142(2):296-308.

Karsenty G, Oury F. The central regulation of bone mass, the first link between bone remodeling and energy metabolism. J Clin Endocrinol Metabo. 2010;95(11):4795-801.

Shao J, Wang Z, Yang T, Ying H, Zhang Y, Liu S. Bone regulates glucose metabolism as an endocrine organ through osteocalcin. International Journal of Endocrinol. 2015;2015:Art. ID 967673.

Dumitru N, Cocolos A, Caragheorgheopol A, Dumitrache C, Bratu OG, Neagu TP, et al. Collagen - the ultrastructural element of the bone matrix. Rev. Chim. (Bucharest), 2018;69(7):1706-9.

Carnevale V, Romagnoli E, D’erasmo L, D’erasmo E. Bone damage in type 2 diabetes mellitus. Nutrit Metabol Cardiovas Dis. 2014;24(11):1151-7.

Stepan JJ. Prediction of bone loss in postmenopausal women. Osteoporos Int. 2000;11Suppl.6:S45-54.

Gilbert MP, Pratley RE. The impact of diabetes and diabetes medications on bone health. Endocrine Rev. 2015;36(2):194-213.

Dumitru N, Carsote M, Cocolos A, Petrova E. Metabolic and bone profile in postmenopausal women with and without type 2 diabetes: a cross-sectional study. Rom J Intern Med. 2019;57(1):61-7.

Nan R, Cursaru A, Grigorie D, Șucaliuc A. Markers of bone turnover and 25(OH) Vit-D in women with T2DM and newly diagnosed osteoporosis. Rom J Diabetes Nutr Metab Dis. 2016;23(1):73-9.

Wang L, Li T, Liu J, Wu X, Wang H, Li X, et al. Association between glycosylated hemoglobin A1c and bone biochemical markers in type 2 diabetic postmenopausal women: a cross-sectional study. BMC Endocrine Disorders. 2019;19(1):31.

Furst JR, Bandeira LC, Fan WW. Advanced glycation Endproducts and bone material strength in type 2 diabetes. J Clin Endocrinol Metab. 2016;101(6):2502-10.

Varma M, Paneri S, Badi P. Correlative study of bone related Biochemical parameters in normal postmenopausal women and hyperglycemic postmenopausal women. Biomed Res. 2005;16(2):129-32.

Shu A, Yin MT, Stein E, Cremers S, Dworakowski E, Ives R, et al. Bone structure and turnover in type 2 diabetes mellitus. Osteoporosis Inter. 2012;23(2):635-41.

Kulkarni SV, Meenatchi S, Reeta R, Ramesh R, Srinivasan AR, Lenin C. Association of glycemic status with bone turnover markers in type 2 diabetes mellitus. Int J App Basic Med Res. 2017;7:247-51.

Movahed A, Larijani B, Nabipour I, Kalantarhormozi M, Asadipooya K, Vahdat K, et al. Reduced serum osteocalcin concentrations are associated with type 2 diabetes mellitus and the metabolic syndrome components in postmenopausal women: the crosstalk between bone and energy metabolism. J Bone Mineral Metab. 2012;30(6):683-91.

Raska I, Raskova M, Zikan V, Skrha J. Body composition is associated with bone and glucose metabolism in postmenopausal women with type 2 DM. Physiol Res. 2017;66:99-111.