Affiliation:
1. Department of Endocrinology, Shanghai Pudong Hospital, Shanghai,
China
2. Clinical Research OB/GYN REI Division, University of
California, San Francisco, USA
Abstract
AbstractThe aim of the study was to investigate whether the biomarkers for bone turnover
could rapidly recover during the period of diabetic ketoacidosis (DKA). Bone
turnover biomarkers, including 25-hydroxyvitamin D3, N-terminal middle molecular
fragment of osteocalcin (NMID), and β-C terminal cross-linking
telopeptide of type 1 collagen were evaluated using in-patient data
(n=627) from Shanghai Pudong Hospital from 2018–2022. The
comparison was performed between type 2 diabetes (T2D only) (n=602) and
DKA (n=25), in which we checked the bone turnover markers at
pre-treatment and recovery. After matching by body mass index (BMI), we found
that except for 25-OH-VitD3, the age difference, indices of glucose metabolism,
and bone turnover were significant between the 2 groups (p<0.05). We
found only a significant restoration of NMID (p<0.001). NMID and
β-CTX, when compared with T2D, showed overt distinction between recovery
and T2D (p<0.05). In addition, the investigations demonstrated a
substantial difference between 25-OH-VitD3 in males and NMID in females,
regardless of age (p<0.05). Multilinear regression analysis revealed
that 2 hours postprandial plasma C-peptide was an independent predictor
of the NMID in both pre-treatment (β=0.58, p=0.003) and
recovery (β=0.447, p=0.025), although sex was
significant in pre-treatment (β=–0.444,
p=0.020). Finally, we found that only age variation affected
DKA’s fasting plasma glucose level (p<0.05). The study revealed
that the bone turnover of DKA is significantly different in pre-treatment and
recovery; however, NMID might recover quickly if the patients received
appropriate treatment. Importantly, pancreatic function plays a critical role in
changing bone turnover biomarkers.