Affiliation:
1. Department of Endocrinology and Metabolism, Molecular Endocrinology Laboratory (KMEB), Odense University Hospital , Odense 5000 , Denmark
2. Department of Clinical Research, University of Southern Denmark , Odense 5000 , Denmark
3. Steno Diabetes Center Odense, Odense University Hospital , Odense 5000 , Denmark
4. Academic Unit of Bone Metabolism, University of Sheffield , Sheffield S10 , UK
5. Mellanby Centre for Musculoskeletal Research, University of Sheffield , Sheffield S10 , UK
Abstract
Abstract
Context
Bone turnover markers (BTMs) are lower in type 2 diabetes mellitus (T2D). The relationships between bone turnover, β-cell function, and insulin sensitivity in T2D are uncertain.
Objective
To investigate if fasting levels of BTMs in persons with T2D are associated with β-cell function or insulin sensitivity.
Methods
We defined three T2D phenotypes, the insulinopenic (low β-cell function, high insulin sensitivity), the classical (low β-cell function, low insulin sensitivity), and the hyperinsulinemic (high β-cell function, low insulin sensitivity) phenotypes, in the Danish Centre for Strategic Research T2D cohort using the homeostatic model assessment. We selected age- and gender-matched subgroups to represent the three T2D phenotypes, yielding 326 glucose-lowering treatment–naïve persons with T2D. Median values of BTMs between the three T2D phenotypes were compared. Regression models were applied to assess the association between BTMs, β-cell function, and insulin sensitivity adjusted for potential confounders.
Results
Median serum levels of procollagen type I N-terminal propeptide, C-terminal telopeptide of type I collagen, and osteocalcin were higher in the insulinopenic phenotype (52.3 μg/L, IQR 41.6, 63.3; 259.4 ng/L, IQR 163.4, 347.7; and 18.0 μg/L, IQR 14.4, 25.2, respectively) compared with the classical (41.4, IQR 31.0, 51.4; 150.4 IQR 103.5, 265.1; 13.1, IQR 10.0, 17.6, respectively) and the hyperinsulinemic (43.7, IQR 32.3, 57.3; 163.3, IQR 98.9, 273.1; 15.7 IQR 10.2, 20.8, respectively) phenotypes (all P < .01). These differences persisted after adjustment for age, sex, waist to hip ratio, or fasting plasma glucose (P < .01).
Conclusion
BTMs are lower in newly diagnosed persons with T2D characterized by low insulin sensitivity.
Funder
European Union’s Horizon 2020
Marie Skłodowska-Curie
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism
Cited by
4 articles.
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