Assessment of bone turnover and vitamin D levels in women with postmenopausal osteoporosis and type 2 diabetes mellitus
J. Novakovic-Paro, B. Vukovic, T. Icin, B. Kovacev-Zavisic, M. Medic-Stojanoska, M. Mitrovic, I. Bajkin & O. Rankov
Background: Past research suggests that diabetes mellitus, although with still insufficiently known mechanisms, has an effect on bone turnover.
Objective of this study was to determine the level of bone metabolism parameters and vitamin D in women with postmenopausal osteoporosis and type 2 diabetes mellitus.: Material and methods
The prospective study included 30 women with postmenopausal osteoporosis and type 2 diabetes mellitus and a controls 30 women with postmenopausal osteoporosis. Osteoporosis is verified by lumbar spine and hip DXA. Levels of osteocalcin, β-crosslaps and 25(OH)D3 were measured.
Results: Diabetes mellitus duration was 15.37±11.08 years. HbA1c was 7.52±1.62%. Women with diabetes mellitus was 61.6±8.07years old and controls 61.9±7.23 years. Women with diabetes mellitus BMI was 26.61±5.45 kg/m2 and 24.77±3.57 kg/m2 for controls. There was no statistically significant difference in age or BMI. Women with diabetes mellitus L1-L4BMD was 0.846±0.075 g/cm2, total hip 0.746±0.108 g/cm2 and femoral neck 0.704±0.078 g/cm2. Controls L1-L4BMD was 0.799±0.058 g/cm2, total hip 0.787±0.085 g/cm2 and femoral neck 0.749±0.084 g/cm2. BMD of the lumbar spine in women with diabetes mellitus were higher, without statistical significance, while the hip BMD was significantly lower on the femur neck (P<0.05). Women with diabetes mellitus osteocalcin was 29.68±11.67 ng/ml, crosslaps 530.73±239.96 pg/ml and 25(OH)D3 37.9±20.22 nmol/l. Controls: osteocalcin 32.83±7.76 ng/ml, crosslaps 525.03±167.94 pg/ml, and 25(OH)D3 40.85±17.79 nmol/l. Among these parameters there was no statistically significant difference. All women with diabetes mellitus had a lack of vitamin D, and 14(46.7%) of them had vitamin D deficiency. Controls: sufficient levels of vitamin D had 2 (6.7%) women; vitamin D deficiency had 9(30%) women.
Conclusion: In women with type two diabetes mellitus bone density at the femur and the femoral neck is lower. There is no statistically significant difference in bone turnover in women with type two diabetes mellitus compared to healthy women with osteoporosis. Inadequacy of vitamin D is more often present in women with type two diabetes mellitus than in healthy women with osteoporosis.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.