Abstract
Aim The study aims to develop a practical model for screening bone turnover state in patients with diabetes and evaluate its clinical usefulness to identify diabetic osteopathy. Materials The study was conducted in 2015–2017 in the Endocrinology Department of the Therapeutic Clinic of AM University. A total of 235 patients were assessed in the study (98 with T1DM and 137 with T2DM). 89 nondiabetic subjects served as controls. Bone mineral density (BMD) [by dual energy X-ray absorptiometry (DXA)] and serum markers of bone remodeling [aminoterminal propeptide of procollagen type I (P1NP) and c-terminal telopeptide of type I collagen (CTX)], parathyrin, and 25(OH)D were measured in all 235 patients. Results Our results show that patients with T2DM have lower b-CTx values and relatively higher levels of P1NP, reflecting less pronounced changes in bone metabolism compared to patients with T1DM, regardless of age or duration of the disease. Osteoporosis was detected in 50% of patients with T1DM, compared to 13% of patients with T2DM. Conclusion In some cases, bone remodeling markers are useful for improving the assessment of the state of bone tissue in early stages of diabetes, while alterations in bone microarchitecture may not always be captured by bone mineral density measurements.
Highlights
Diabetes-related complications are a consequence of severe metabolic disorders in the body
There are multiple factors that increase the risk of bone turnover disorders. erefore, we compared biochemical markers of bone metabolism in the same-aged patients, both healthy and with diabetes. e institutionalized group comprised only patients with well-controlled diabetes without late-stage complications
Low levels of Mg2+ can reduce the activity of PTH, reducing the synthesis of alpha 1-hydroxylase. is in turn reduces the concentration of the active form of vitamin D and Ca2+in serum, adversely affecting the metabolism of the mineral component of the bone and changing the structure of hydroxyapatite crystals and the overall architecture of the bone [2]
Summary
Diabetes-related complications are a consequence of severe metabolic disorders in the body. E level of PTH among groups of patients with T1DM and T2DM was slightly higher than the values of this indicator in the control group (p < 0.05).
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