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Glycemic control and bone metabolism in postmenopausal women with type 2 diabetes mellitus

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Abstract

Objective

Diabetes mellitus type 2 (T2DM) has accumulated attention as a fracture risk in osteoporosis. In the present study, we investigated the effect of glycemic level, its control, and its treatment on bone mineral density (BMD) and bone metabolism focusing on Japanese postmenopausal women with T2DM.

Methods

BMD was determined by dual-energy X-ray absorptiometry to calculate T score and Z score at the lumbar spine at L2–4. Bone metabolic markers such as serum type 1 collagen cross-linked N-telopeptides (sNTX), a marker of bone resorption, and serum bone-specific alkaline phosphatase (BAP), a marker of bone formation, were measured.

Results

We enrolled 55 Japanese postmenopausal women with T2DM [initial age 63.5 ± 7.7 years, BMI 22.8 ± 3.5 kg/m2, hemoglobin A1c (HbA1c) 7.53 ± 1.94% (HbA1c Japanese Diabetes Society; JDS) 7.26 ± 1.68%], L2–4 BMD 0.927 ± 0.169 g/cm2, T score −0.738 ± 1.527; Z score 0.945 ± 1.272]. There were no significant differences on L2–4 BMD, T score, Z score, or bone metabolic markers among three treatment groups regarding diet, orally administered medication, and insulin. In the analysis of correlation coefficients, HbA1c significantly correlated with sNTX (r = 0.363, p = 0.008), and the significant, but weak, correlation was observed between HbA1c and Z score (r = 0.306, p = 0.026). In patients newly treated with intensive insulin therapy (n = 5), glycemic control significantly suppressed sNTX after 3 months (p < 0.05).

Conclusions

The control of glycemic level might be correlated with osteoclast function in terms of bone resorption marker, which might be linked with fracture risk in postmenopausal women with T2DM.

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Conflict of interest

The authors declare that they have no conflict of interest

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Authors and Affiliations

  1. Department of Medicine, Chiba Aoba Municipal Hospital, Chiba, Japan

    Takashi Terano & Kyohei Yamamoto

  2. Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan

    Sawako Suzuki, Tomohiko Yoshida, Hidekazu Nagano, Naoko Hashimoto, Takafumi Mayama, Hisashi Koide, Keiko Suyama & Tomoaki Tanaka

  3. Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan

    Ichiro Tatsuno

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  1. Takashi Terano
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  2. Sawako Suzuki
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Correspondence to Ichiro Tatsuno.

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Terano, T., Suzuki, S., Yoshida, T. et al. Glycemic control and bone metabolism in postmenopausal women with type 2 diabetes mellitus. Diabetol Int 3, 68–74 (2012). https://doi.org/10.1007/s13340-011-0058-3

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  • DOI: https://doi.org/10.1007/s13340-011-0058-3

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