Association of bone turnover markers with glucose metabolism in type 2 diabetes mellitus

Abstract

Introduction and Aim: Type 2 diabetes mellitus (Type 2 DM) subjects are at increased risk of fracture due to poor bone quality contributing to diabetic skeletal fragility. This study provides an understanding of the relationship between bone turnover markers (BTM) and glucose metabolism in Type 2 DM. Materials and Methods: One hundred types 2 diabetics and one hundred controls participated in this case control study. Serum FBS, osteocalcin, alkaline phosphatase (ALP), CTx (C- terminal cross linked telopeptide of type 1 collagen), HOMA-IR and HOMA-B was measured. Association between BTM and FBS, HOMA-IR and HOMA-B was studied. Comparison was done by Student’s t test. The correlation was established using Pearson's correlation test. P value less than 0.05 was used to determine statistical significance. Results: Mean levels of FBS, ALP and HOMA-IR were higher and mean levels of osteocalcin, CTx and HOMA-B were decreased in diabetics when compared to controls. Osteocalcin levels showed significant negative correlation with FBS, ALP, HOMA-B and HOMA-IR. CTx levels were negatively correlated with ALP and FBS. Conclusion: Early identification of decrease in bone mass in diabetic patients may be helpful in preventing bone loss and future fracture risks. Monitoring for diabetes associated with osteopenia is essential. The biochemical markers of bone metabolism can detect even small changes in the bone turnover, thus identifying diabetics who may become osteoporosis-prone.