Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 World cup-ro, Suwon, 16499, South Korea.
Department of Endocrinology and Metabolism, Kosin University School of Medicine, Busan, South Korea.
Osteoporos Int. 2018 Apr;29(4):907-915. doi: 10.1007/s00198-017-4359-7. Epub 2018 Jan 10.
Pentosidine levels were higher in diabetic patients with vertebral fractures. Trabecular bone scores were negatively associated with pentosidine levels in diabetic patients only. Our results provide further evidence that AGEs are associated with the pathogenesis of bone fragility in patients with T2DM.
Type 2 diabetes mellitus (T2DM) is associated with fracture risk. Pentosidine, an advanced glycation end product (AGE), is associated with prevalent vertebral fractures (VFs) in patients with T2DM. Trabecular bone score (TBS) has been proposed as an index of bone microarchitecture associated with bone quality. This study evaluated the associations of urine pentosidine and TBS in T2DM and non-T2DM groups.
A total of 112 T2DM patients and 62 non-T2DM subjects were enrolled. TBS was calculated using TBS insight® software (version 2.1). Pentosidine levels were measured using high-performance liquid chromatography method. We compared the BMD, TBS, and pentosidine levels between those with and without VFs with or without adjustment for age and sex. The association with TBS, lumbar spine BMD, and pentosidine levels were also evaluated in both T2DM and non-T2DM groups.
Pentosidine levels were significantly higher in T2DM patients with VFs. TBSs were significantly lower in patients with T2DM and VFs. In non-diabetic patients, there were no significant differences in TBS and pentosidine levels for those with and without VFs after adjustment for age and sex. Pentosidine levels were negatively associated with TBS only in patients with T2DM. In multivariate stepwise regression analysis, pentosidine levels were significantly associated with TBS in patients with T2DM.
TBS and pentosidine could be used as a method to assess bone quality to identify T2DM patients at risk of VFs. Our results also provide further evidence that AGEs are associated with the pathogenesis of bone fragility in patients with T2DM.
糖尿病合并椎体骨折患者的戊糖含量较高。只有在糖尿病患者中，小梁骨评分与戊糖含量呈负相关。我们的研究结果进一步证明，AGEs 与 T2DM 患者的骨脆弱发病机制有关。
2 型糖尿病（T2DM）与骨折风险相关。戊糖是一种晚期糖基化终产物（AGE），与 T2DM 患者的常见椎体骨折（VF）有关。骨小梁评分（TBS）已被提议作为与骨质量相关的骨微结构指数。本研究评估了 T2DM 和非 T2DM 组中尿液戊糖和 TBS 的相关性。
共纳入 112 例 T2DM 患者和 62 例非 T2DM 患者。使用 TBS insight®软件（版本 2.1）计算 TBS。使用高效液相色谱法测量戊糖水平。我们比较了有和无 VF 的患者以及有和无 VF 的患者的 BMD、TBS 和戊糖水平，调整了年龄和性别。还评估了 T2DM 和非 T2DM 组中 TBS、腰椎 BMD 和戊糖水平的相关性。
T2DM 合并 VF 患者的戊糖水平明显较高。TBS 在 T2DM 合并 VF 患者中明显较低。在非糖尿病患者中，调整年龄和性别后，有和无 VF 的患者的 TBS 和戊糖水平无显著差异。只有在 T2DM 患者中，戊糖水平与 TBS 呈负相关。多元逐步回归分析显示，T2DM 患者的戊糖水平与 TBS 显著相关。
TBS 和戊糖可作为评估骨质量的方法，以识别有 VF 风险的 T2DM 患者。我们的研究结果还进一步证明，AGEs 与 T2DM 患者的骨脆弱发病机制有关。
