Katrine Hygum1, Jakob Starup-Linde1,2, Torben Harsløf1, Peter Vestergaard3, Bente L Langdahl1. 1. Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus C, Denmark. 2. Department of Infectious DiseasesAarhus University Hospital, Aarhus N, Denmark. 3. Department of Clinical Medicine and EndocrinologyAalborg University Hospital, Aalborg, Denmark.
Abstract
OBJECTIVE: To investigate the differences in bone turnover between diabetic patients and controls. DESIGN: A systematic review and meta-analysis. METHODS: A literature search was conducted using the databases Medline at PubMed and EMBASE. The free text search terms 'diabetes mellitus' and 'bone turnover', 'sclerostin', 'RANKL', 'osteoprotegerin', 'tartrate-resistant acid' and 'TRAP' were used. Studies were eligible if they investigated bone turnover markers in patients with diabetes compared with controls. Data were extracted by two reviewers. RESULTS: A total of 2881 papers were identified of which 66 studies were included. Serum levels of the bone resorption marker C-terminal cross-linked telopeptide (-0.10 ng/mL (-0.12, -0.08)) and the bone formation markers osteocalcin (-2.51 ng/mL (-3.01, -2.01)) and procollagen type 1 amino terminal propeptide (-10.80 ng/mL (-12.83, -8.77)) were all lower in patients with diabetes compared with controls. Furthermore, s-tartrate-resistant acid phosphatase was decreased in patients with type 2 diabetes (-0.31 U/L (-0.56, -0.05)) compared with controls. S-sclerostin was significantly higher in patients with type 2 diabetes (14.92 pmol/L (3.12, 26.72)) and patients with type 1 diabetes (3.24 pmol/L (1.52, 4.96)) compared with controls. Also, s-osteoprotegerin was increased among patients with diabetes compared with controls (2.67 pmol/L (0.21, 5.14)). CONCLUSIONS: Markers of both bone formation and bone resorption are decreased in patients with diabetes. This suggests that diabetes mellitus is a state of low bone turnover, which in turn may lead to more fragile bone. Altered levels of sclerostin and osteoprotegerin may be responsible for this.
OBJECTIVE: To investigate the differences in bone turnover between diabeticpatients and controls. DESIGN: A systematic review and meta-analysis. METHODS: A literature search was conducted using the databases Medline at PubMed and EMBASE. The free text search terms 'diabetes mellitus' and 'bone turnover', 'sclerostin', 'RANKL', 'osteoprotegerin', 'tartrate-resistant acid' and 'TRAP' were used. Studies were eligible if they investigated bone turnover markers in patients with diabetes compared with controls. Data were extracted by two reviewers. RESULTS: A total of 2881 papers were identified of which 66 studies were included. Serum levels of the bone resorption marker C-terminal cross-linked telopeptide (-0.10 ng/mL (-0.12, -0.08)) and the bone formation markers osteocalcin (-2.51 ng/mL (-3.01, -2.01)) and procollagen type 1 amino terminal propeptide (-10.80 ng/mL (-12.83, -8.77)) were all lower in patients with diabetes compared with controls. Furthermore, s-tartrate-resistant acid phosphatase was decreased in patients with type 2 diabetes (-0.31 U/L (-0.56, -0.05)) compared with controls. S-sclerostin was significantly higher in patients with type 2 diabetes (14.92 pmol/L (3.12, 26.72)) and patients with type 1 diabetes (3.24 pmol/L (1.52, 4.96)) compared with controls. Also, s-osteoprotegerin was increased among patients with diabetes compared with controls (2.67 pmol/L (0.21, 5.14)). CONCLUSIONS: Markers of both bone formation and bone resorption are decreased in patients with diabetes. This suggests that diabetes mellitus is a state of low bone turnover, which in turn may lead to more fragile bone. Altered levels of sclerostin and osteoprotegerin may be responsible for this.
Authors: Hema Kalyanaraman; Gerburg Schwaerzer; Ghania Ramdani; Francine Castillo; Brian T Scott; Wolfgang Dillmann; Robert L Sah; Darren E Casteel; Renate B Pilz Journal: Diabetes Date: 2018-01-04 Impact factor: 9.461
Authors: Viral N Shah; R Dana Carpenter; Virginia L Ferguson; Ann V Schwartz Journal: Curr Opin Endocrinol Diabetes Obes Date: 2018-08 Impact factor: 3.243
Authors: David R Weber; Rebecca J Gordon; Jennifer C Kelley; Mary B Leonard; Steven M Willi; Jacquelyn Hatch-Stein; Andrea Kelly; Oksana Kosacci; Olena Kucheruk; Mirna Kaafarani; Babette S Zemel Journal: J Clin Endocrinol Metab Date: 2019-10-01 Impact factor: 5.958