HEALTH OF WOMAN. 2016.3(109):115–119; doi 10.15574/HW.2016.109.115 
 

Effects of type 2 diabetes mellitus on bone metabolism in postmenopausal women 
 

Atanova Ya. O., Kyrylyuk M. L.

Ukrainian scientific and practical center for endocrine surgery, transplantation of endocrine organs and tissues Ministry of Ukraine,

Clinic of family medicine «Zdravytsya», Kyiv 
 

To date, the issues concerning the effects of key features of type 2 diabetes mellitus (DM) (compensation of carbohydrate metabolism, duration of the disease, obesity degree) on bone metabolism continue to be relevant, particularly during the postmenopausal period, which requires a subsequent study.

The objective: to study the effects of type 2 DM on the parameters of bone metabolism in postmenopausal women with 2 type DM taking into consideration the duration of the disease, the degree of diabetes compensation and the degree of obesity.

Patients and methods. Eighty-seven women were examined, who were divided into 2 groups: the first – 56 apparently healthy postmenopausal women (average age of 58.41±1.17 years), the second – 31 female patients with 2 type MD (average age of 63±1.21 years, HbA1c of 9.07±0.36 %, average diabetes duration of 12.05±1.37 years). The condition of bone metabolism was evaluated according to the blood serum content of the markers of osteodestruction (type I collagen degradation products – b-CrossLaps) and of osteogenesis (osteocalcin). The b-CrossLaps and osteocalcin concentrations were determined by enzyme-immunoassay using ROSHE HITACHI Cobas e 411 automatic analyzer (Germany) with the use of b-CrossLaps/serum ROSHE and N-MID Osteocalcin ROSHE reagents. Comparison of the independent samples was performed by analysis of variance with the use of the F-test and Kruskal–Wallis non-parametric test.

Results. The one-way analysis of variance showed that the b-CrossLaps and osteocalcin concentrations in the women with 2 type DM were significantly lower compared to the control group. The regression analysis revealed a complex polynomial dependence of the в-CrossLaps concentration on the BMI, which is described by a second-order equation with the following parameters R2=29.9%; p=0.01. It was demonstrated that, in patients with 2 type MD and BMI Ј35 kg/m2, an opposite nonlinear association occurred between the в-CrossLaps and HbA1c concentrations (r=-0.52; R2=27.3%; p=0.01). In patients with 2 type DM and BMI >35 kg/m2, a direct association between b-CrossLaps and HbA1c is observed (r=0.67; R2=45.6%; p=0.03). It was established that in patients with the diabetes duration up to 10 years, there was an opposite association between osteocalcin and HbA1c (r=-0.67; R2=44.8%; p=0.001). The consideration of the role of the body weight in the transformation of bone remodelling revealed a significant opposite association between the osteocalcin concentration and the HbA1с level (r=-0.57; R2=32.7%; p=0.05; N=11) only in the group of patients with BMI <30 kg/m2.

Conclusions. Type 2 diabetes mellitus results in a decrease in the blood content of type I collagen degradation products and osteocalcin in postmenopausal women. The interrelation of the b-CrossLaps concentration and type 2 MD and BMI of the patient is complex polynomial dependence in nature. Postmenopausal women with 2 or 3 degree of obesity and an unsatisfactory control of 2 type MD are in the risk group in terms of increase in bone resorption. A decrease in bone resynthesis processes in postmenopausal women with 2 type MD occurs already at the early stage of disease and is due to the glycemic control quality. The study findings and literature data show that there are some new links of 2 type MD pathogenesis during the postmenopausal period, which gives grounds for search of new approaches to 2 type DM and obesity treatment in elderly women with the use of novel synthetic equivalents of osteocalcin.

Key words: menopause, 2 type diabetes mellitus, markers of osteoporosis.

REFERENCES

1. Kanazawa I. 2012, Sep. Diabetes mellitus and osteoporosis. The regulation of glucose metabolism by bone. Article in Japanese. Clin Calcium. 22(9):1375–82. doi: CliCa 120913751382.

2. Кирилюк МЛ. 2013. Остеопороз і цукровий діабет. Цукровий діабет у практиці сімейного лікаря (практичний посібник). За редакцією ОС Ларіна. К, УНПЦЕХ, ТЕіОТ МОЗ України:73–77.

3. Im JA, Yu BP, Jeon JY, Kim SH. 2008. Relationship between osteocalcin and glucose metabolism in postmenopausal women. Clin Chim Acta. 396:66–9. http://dx.doi.org/10.1016/j.cca.2008.07.001; PMid:18657532

4. Kuљec V. 2016. The skeleton in diabetes – involvement and interaction. Periodicum Biologorum. 117(1):87–93.

5. Ломова АВ. 2014. Состояние костной ткани у женщин с сахарным диабетом 2 типа в пре- и постменопаузе. Автореф. дисс. канд. мед. наук: 14.01.02. (Место защиты: Научно-исследовательский институт терапии СО РАМН – Учреждение РАМН). Новосибирск:168.

6. Мкртумян АМ. 2014. Современные возможности решения проблемы остеопороза у пациентов с сахарным диабетом 2 типа. Эффективная фармакотерапия 53:70–76.

7. Norihiro Furusyo. 2014. The Association between Serum under carboxylated Osteocalcin Level and Type-2 Diabetes Mellitus: Results from the Kyushu and Okinawa Population Study. Clin Res Dev Open Access. 1:110 http: //dx. doi. org/10. 14437/CRDOA-1-110.

8. Otta C, Jacobsb K, Hauckec E, Santos AN, Grune T, Simm A. 2016. Role of advanced glycation end products in cellular signaling. Redox Biology. 2:411–429. http://dx.doi.org/10.1016/j.redox.2013.12.016; PMid:24624331 PMCid:PMC3949097.