Bone microarchitecture, bone mineral density and bone turnover in association with glycemia and insulin action in women with prior gestational diabetes.
bone
bone mineral density
gestational diabetes
insulin
osteocalcin
trabecular bone score
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
09
10
2021
received:
21
07
2021
accepted:
04
11
2021
pubmed:
25
11
2021
medline:
21
4
2022
entrez:
24
11
2021
Statut:
ppublish
Résumé
The aim of this cross-sectional study was to comprehensively assess bone health in women with prior gestational diabetes mellitus, including bone microarchitecture (TBS), bone mineral density (BMD, DXA) and bone turnover (osteocalcin). Study participants underwent a detailed anthropometric, biochemical and hormone assessment, including insulin and osteocalcin measurement. BMD was measured at lumbar spine, femur neck and total hip using DXA and TBS derived from lumbar spine DXA images using TBS iNsight software. A total of 240 women (mean age: 33.3 ± 5.0 years; median postpartum duration: 34 [interquartile range 13.0-54.5] months were evaluated. At the current visit, 115 (47.9%) and 36 (15%) women had prediabetes and diabetes, respectively. Women with dysglycemia (diabetes/prediabetes) had a higher BMD at all three sites, compared to those with normoglycemia; however, the difference was not statistically significant. Women with dysglycemia had a significantly lower TBS (1.32 ± 0.09 vs. 1.35 ± 0.09; p = .038). In the fully adjusted model, the odds ratio for association between diabetes and low TBS was 2.92 (95% confidence interval: 1.20, 7.08; p = .018). Women with dysglycemia had significantly lower serum osteocalcin levels (18.6 ± 8.5 ng/ml vs. 21.5 ± 9.7 ng/ml; p = .018). HOMA-IR (r = -.285, p < .001) was negatively correlated, while Matsuda index (r = .274, p < .001) and disposition index (r = .159, p = .016) were positively correlated with serum osteocalcin levels. Bone health is affected early in the natural history of diabetes and is associated with an overall low bone turnover state.
Substances chimiques
Blood Glucose
0
Insulin
0
Osteocalcin
104982-03-8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
531-538Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Vilaca T, Schini M, Harnan S, et al. The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: a systematic review and meta-analysis update. Bone. 2020;137:115457.
Valderrábano RJ, Linares MI. Diabetes mellitus and bone health: epidemiology, etiology and implications for fracture risk stratification. Clin Diabetes Endocrinol. 2018;4:9.
Srikanthan P, Crandall CJ, Miller-Martinez D, et al. Insulin resistance and bone strength: findings from the study of midlife in the United States. J Bone Miner Res. 2014;29(4):796-803.
Shin D, Kim S, Kim KH, Lee K, Park SM. Association between insulin resistance and bone mass in men. J Clin Endocrinol Metab. 2014;99(3):988-995.
Ho-Pham LT, Tran B, Do AT, Nguyen TV. Association between pre-diabetes, type 2 diabetes and trabecular bone score: the Vietnam Osteoporosis Study. Diabetes Res Clin Pract. 2019;155:107790.
Jang M, Kim H, Lea S, Oh S, Kim JS, Oh B. Effect of duration of diabetes on bone mineral density: a population study on East Asian males. BMC Endocrinol Disord. 2018;18(1):61.
Iki M, Fujita Y, Kouda K, et al. Hyperglycemic status is associated with an elevated risk of osteoporotic fracture in community-dwelling elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) cohort study. Bone. 2019;121:100-106.
Ho-Pham LT, Nguyen TV, et al. Association between trabecular bone score and type 2 diabetes: a quantitative update of evidence. Osteoporosis Int. 2019;30:2079-2085.
Ma L, Oei L, Jiang L, et al. Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol. 2012;27:319-332.
Serra MC, Ryan AS. Influence of vitamin D and parathyroid hormone on bone and metabolic risk in women with previous gestational diabetes. Horm Metab Res. 2016;48:497-502.
Engberg E, Koivusalo SB, Huvinen E, Viljakainen H. Bone health in women with a history of gestational diabetes or obesity. Acta Obstet Gynecol Scand. 2020;99:477-487.
Kubihal S, Gupta Y, Shalimar, et al. Prevalence of non-alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus. J Diabetes Investig. 2021;12:877-885.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33:676-682.
Goyal A, Gupta Y, Kalaivani M, et al. Concordance of glycaemic and cardiometabolic traits between Indian women with history of gestational diabetes mellitus and their spouses: an opportunity to target the household. Diabetologia. 2019;62:1357-1365.
GPAQ_Analysis_Guide.pdf. Accessed May 2, 2021. https://www.who.int/ncds/surveillance/steps/resources/GPAQ_Analysis_Guide.pdf
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(suppl 1):S14-S31.
Assessment of bone mineral density in adults. Accessed May 2, 2021. https://iscd.org/learn/official-positions/adult-positions/
McCloskey EV, Odén A, Harvey NC, et al. A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res. 2016;31:940-948.
Goyal A, Gupta Y, Kalaivani M, et al. Long term (>1 year) postpartum glucose tolerance status among Indian women with history of gestational diabetes mellitus (GDM) diagnosed by IADPSG criteria. Diabetes Res Clin Pract. 2018;142:154-161.
Gower BA, Casazza K. Divergent effects of obesity on bone health. J Clin Densitom. 2013;16:450-454.
Cao JJ. Effects of obesity on bone metabolism. J Orthop Surg. 2011;6:30.
Shah VN, Sippl R, Joshee P, et al. Trabecular bone quality is lower in adults with type 1 diabetes and is negatively associated with insulin resistance. Osteoporos Int. 2018;29:733-739.
Campillo-Sánchez F, Usategui-Martín R, Ruiz-de Temiño Á, et al. Relationship between insulin resistance (HOMA-IR), trabecular bone score (TBS), and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in non-diabetic postmenopausal women. J Clin Med. 2020;9(6):1732.
Shanbhogue VV, Finkelstein JS, Bouxsein ML, Yu EW. Association between insulin resistance and bone structure in nondiabetic postmenopausal women. J Clin Endocrinol Metab. 2016;101(8):3114-3122.
Hygum K, Starup-Linde J, Harsløf T, Vestergaard P, Langdahl BL. Mechanisms in endocrinology: diabetes mellitus, a state of low bone turnover-a systematic review and meta-analysis. Eur J Endocrinol. 2017;176:R137-R157.
Dobnig H, Piswanger-Sölkner JC, Roth M, et al. Type 2 diabetes mellitus in nursing home patients: effects on bone turnover, bone mass, and fracture risk. J Clin Endocrinol Metab. 2006;91:3355-3363.
Kanazawa I, Yamaguchi T, Yamamoto M, et al. Serum osteocalcin level is associated with glucose metabolism and atherosclerosis parameters in type 2 diabetes mellitus. J Clin Endocrinol Metab. 2009;94(1):45-49.