Bone remodeling in patients with type I and type II diabetes mellitus in pre- and postmenopausal periods

Abstract

Aim: to perform structural and functional analysis of the activity of reparative osteogenesis processes at pre- and postmenopausal women with diabetes mellitus (DM).Materials and Methods. There were enrolled 142 pre- and postmenopausal patients with type I and type II diabetes mellitus type (DM-1 and DM-2) as well as 43 females in control group. Subjects taking medicines acting on bone metabolism comorbid with chronic diseases were excluded from the study. All patients underwent Dual-energy X-ray Absorptiometry (DXA) to assess bone mineral density (BMD, T-score). Serum markers of bone remodeling (alkaline phosphatase, ALP; procollagen type I N propeptide, PINP; beta-Cross laps, b-CTx), metabolic and hormone parameters (glycated hemoglobin, parathyroid hormone, calcitonin, vitamin D, electrolytes) were also measured.Results. A positive correlation was found between the duration of DM-1 and DM-2 and b-CTx level (DM-1: г = 0.349, р = 0.08; DM-2: г = 0.214, р = 0.04). A negative correlation was found between the lumbar spine T-score and the duration of diabetes (DM-1: r = -0.568, p = 0.001; DM-2: r = -0.267, p = 0.04). A statistically significant correlation was found between the lumbar spine T-score and b-CTx levels (DM-1: r = -0.452, p = 0.002; DM-2: r = -0.357, p = 0.09).Conclusion. The results of current study suggest that reparative osteogenesis in patients with post-menopausal DM-1 vs. DM-2 and the control group was moderately increased. In patients with DM-2, a less pronounced change in BMD was determined in parallel with inconsistent bone remodeling processes, which casts doubt on the ability of DXA to predict fractures in these patients. Such changes contribute to decreased bone quality, which distinguishes diabetic osteopathy from traditional menopausal osteoporosis manifested mainly by low BMD.