Nasser, M.I. orcid.org/0000-0003-3525-592X, Stidsen, J.V. orcid.org/0000-0003-2711-5927, Højlund, K. orcid.org/0000-0002-0891-4224 et al. (3 more authors) (2023) Low bone turnover associates with lower insulin sensitivity in newly diagnosed drug-naïve persons with type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism. dgad043. ISSN 0021-972X
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.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2023. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. |
Keywords: | CTX; PINP; Type 2 diabetes mellitus; insulin; sensitivity; β-cell function |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology and Metabolism (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 09 Jun 2023 10:38 |
Last Modified: | 09 Jun 2023 10:38 |
Status: | Published online |
Publisher: | The Endocrine Society |
Refereed: | Yes |
Identification Number: | https://doi.org/10.1210/clinem/dgad043 |
Related URLs: |