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Association of C-peptide level with bone mineral density in type 2 diabetes mellitus

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Abstract

Summary

This study revealed that there was no significant linear relationship between fasting C-peptide (FCP) level and bone mineral density (BMD) or fracture risk in type 2 diabetes mellitus (T2DM) patients. However, in the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with whole body (WB), lumbar spine (LS), and femoral neck (FN) BMD and negatively correlated with fracture risk.

Purpose

To explore the relationship between C-peptide and BMD and fracture risk in T2DM patients.

Methods

530 T2DM patients were enrolled and divided into three groups by FCP tertiles, and the clinical data were collected. BMD was measured by dual-energy X-ray absorptiometry (DXA). The 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was evaluated by adjusted fracture risk assessment tool (FRAX).

Results

In the FCP ≤ 1.14 ng/ml group, FCP level was positively correlated with WB, LS, and FN BMD, while FCP was negatively correlated with fracture risk and osteoporotic fracture history. However, FCP was not correlated with BMD and fracture risk and osteoporotic fracture history in the 1.14 < FCP ≤ 1.73 ng/ml and FCP > 1.73 ng/ml groups. The study has shown that FCP was an independent factor influencing BMD and fracture risk in the FCP ≤ 1.14 ng/ml group.

Conclusions

There is no significant linear relationship between FCP level and BMD or fracture risk in T2DM patients. In the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with WB, LS, and FN BMD and negatively correlated with fracture risk, and FCP is an independent influencing factor of BMD and fracture risk. The findings suggest that FCP may predict the risk of osteoporosis or fracture in some T2DM patients, which has a certain clinical value.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

BMD :

Bone mineral density

T2DM :

Type 2 diabetes mellitus

DXA :

Dual-energy X-ray absorptiometry

FCP :

Fasting C-peptide

MOFs :

Major osteoporotic fractures

HFs :

Hip fractures

FRAX :

Fracture risk assessment tool

WB :

Whole body

LS :

Lumbar spine

FN :

Femoral neck

FINS :

Fasting insulin

HbA1c :

Glycated hemoglobin A

PTH :

Parathyroid hormone

25(OH)D :

25 Hydroxyvitamin D

PINP :

Procollagen type I N-propeptide

β-CTx :

Beta-isomer of the C-terminal telopeptide of type I collagen

FBG :

Fasting blood glucose

Cr :

Creatinine

TC :

Total cholesterol

TG :

Triglyceride

HDL-C :

High-density lipoprotein cholesterol

LDL-C :

Low-density lipoprotein cholesterol

Ca :

Serum calcium

P :

Serum phosphorus

ALP :

Alkaline phosphatase

ANOVA :

Analysis of variance

IQR :

Interquartile ranges

BMI :

Body mass index

TGF-β1 :

Transforming growth factor-β1

BMP2 :

Bone morphogenetic protein 2

OVX rats :

Ovariectomized rats

RANKL :

Receptor activator nuclear factor kappa B ligand

Na + -K + ATPase :

Sodium-potassium ATPase

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Acknowledgements

We thank all patients and their families for consenting use their medical documentations and information that lead to our paper.

Funding

This work was supported by the Clinical Medical Research Center of Endocrine Diseases of Gansu Province [No. 20JR10FA667], the Science and Technology Planning Project of Lanzhou Chengguan District [No. 2021JSCX0011], and the Natural Science Foundation of Gansu Province in 2021 [No. 21JR1RA080].

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Authors and Affiliations

  1. The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China

    Hong Yang, Jia Bai, Lingling Li, Ying Yang & Yangyang Zhang

  2. Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

    Haihong Lv & Songbo Fu

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  1. Hong Yang
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Yang, H., Bai, J., Li, L. et al. Association of C-peptide level with bone mineral density in type 2 diabetes mellitus. Osteoporos Int 34, 1465–1476 (2023). https://doi.org/10.1007/s00198-023-06785-9

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