Patients with type 2 diabetes (T2DM) have an increased risk of hip and vertebral fractures compared to non-T2DM subjects. The bone mineral density (BMD) does not reflect the impaired bone quality in T2DM patients. The aim of the present study was to investigate the relationship between BMD and bone formation (N-terminal propeptide of type I procollagen, PINP; osteocalcin, OC) and bone resorption (cross-linked C-telopeptides of bone type I collagen, CTX) markers, as well as changes in 25 hydroxyvitamin D (25OHD) and plasma sclerostin levels in patients with T2DM and healthy controls. In a cross sectional study, we compared 110 diabetic patients with 103 healty non-T2DM controls. The prevalance of vitamin D insuficiency in T2DM patients was higher compared to healthy controls. Our preliminary data showed that patients with T2DM without osteoporosis have lower bone remodeling markers (CTX, OC, PINP) compared to healthy controls. Patients with T2DM with a vertebral fracture have a lower CTX and OC when compared to T2DM patients with osteoporosis and/or with non-vertebral fracture and also when compared to non-diabetic controls with prevalent vertebral fracture. Serum sclerostin levels were positively correlated with bone mineral density of the lumbar spine, femoral neck and whole body bone density in patients with T2DM. Our findings suggests differences in bone remodeling in T2DM patients that can play an important role in pathogenesis of bone fragility in these patients.
17 May 2014 - 20 May 2014