Altered bone metabolic markers in type 2 diabetes mellitus impact of glycemic control

Abstract

Objective To study the influence of glycemic control on bone minerals and biochemical markers of bone metabolism in patients with type 2 diabetes mellitus Methods A Casecontrol study was conducted at Uhod Hospital KSA from October 2003 to August 2004 to study 60 premenopausal multipareous female patients with type 2 diabetes mellitus for >5 years under oral antidiabetics with no diabetic complications They were divided according to their glycemic control into controlled group (n22) and poorly controlled group (n38) and were compared to 30 age matched healthy women Osteocalcin (OC) urinary deoxypyridinoline (Dpd) Parathyroid hormone (PTH) were measured by chemiluminescent enzyme immunometric assay and 25 hydroxy vitamin D (25 OHD) was measured by high performance liquid chromatography Results In both diabetic groups there were higher ALP (177± 3988 & 287 ± 414 mgdl) and PTH (49 ±987 & 5625± 123 Pgml) than in controls (144 ± 2254 mgdl 269± 560 Pgml respectively ) but lower serum calcium (887± 03 & 879 ±07 mgdl) and 25 OHD (509±126 454±189 gl) and osteocalcin (409 ± 148 & 189 ± 024 ngml) than controls (996± 19l 579±136 gl 65±15 ngml respectively) Urinary calcium and urinary Dpd were higher (27066±417 & 30056 ± 5567 mgd & 108 ± 46 1206±512 nMmM creatinine) than in controls (24423 ±515 mgd 62 ±08 nMmM creatinine) Glycemic indices (FBG HbA1C) showed significant positive correlation with ALP (r0290 & 0294) urinary calcium (r0340 & 0260) and Dpd (r0468 & 0228) Conclusion Our data give evidence of altered bone metabolic markers in both controlled and uncontrolled female patients with type 2 diabetes mellitus with more significant alterations in the uncontrolled group This could reflect the strong impact of glycemic control on diabetic bone turnover