Abstract
BackgroundThe study was planned to assess effect of physical exercise on bone remodeling in type I diabetics with osteopenia.MethodsTwenty-four type I diabetes mellitus (DM1) with osteopenia (10 females and 14 males) were compared to thirty-eight age- and sex-matched healthy control individuals (20 females and 18 males) for biochemical and radiologic parameters of bone mass. Laboratory investigations included serum and urinary calcium, inorganic phosphorus, alkaline phosphatase, and serum "procollagen type 1 N-terminal propeptide (P1NP). Bone densitometry was assessed at neck femur using Dual Energy X-ray Absorptiometry (DEXA). Serum P1NP and DEXA were reevaluated after a planned exercise program.ResultsPatients and controls were comparable with respect to serum as well as urinary biochemical parameters of bone mass namely; calcium, phosphorus and total serum alkaline phosphatase. Osteopenic DM1 patients displayed lower mean serum P1NP than control group (20.11 ± 6.72 ug\\dL versus 64.96 ± 34.89 ug\\dL; p < 0.05). A significant correlation was observed between BMD and degree of glycemic control reflected by serum glycated hemoglobin (r = -0.44, p, 0.030). Bone densitometry correlated with serum P1NP (r = -0.508, p, 0.011). After a planned regular exercise for 3 months, serum P1NP and BMD levels increased with percentage change of 40.88 ± 31.73 and 3.36 ± 2.94, respectively. Five patients resumed normal densitometry and they were all males.ConclusionDiabetic osteopenic patients displayed lower serum levels of procollagen type 1 N-terminal propeptide which reflects poor bone formation. A 3-months planned exercise program was associated with improvement of bone densitometry and significant increment of serum P1NP.
Highlights
The study was planned to assess effect of physical exercise on bone remodeling in type I diabetics with osteopenia
The glycemic response depends largely on the type, intensity and duration of the activity, circulating insulin and glucose counter regulatory hormone concentrations, type and timing of food, metabolic control, muscle mass/number of muscles used in activity, conditioning, and Degree of stress/competition involved in the activity and timing of activity [5,6,7]
Serum procollagen type 1 N-terminal propeptide (P1NP) was estimated using rapid equilibrium radioimmunoassay [8] before and after exercise program
Summary
The study was planned to assess effect of physical exercise on bone remodeling in type I diabetics with osteopenia. Bone formation at patients, vigorous exercise can cause major disturbances in blood glucose. The glycemic response depends largely on the type, intensity and duration of the activity, circulating insulin and glucose counter regulatory hormone concentrations, type and timing of food, metabolic control, muscle mass/number of muscles used in activity, conditioning, and Degree of stress/competition involved in the activity and timing of activity [5,6,7]. The current prospective study was planned to assess bone remodeling status in osteopenic DM1 patients and its relation to diabetes duration and glycemic control, and the effect of planned physical exercise on bone mass
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