Rianon Nahid J, Smith Scott M, Lee MinJae, Pervin Hannah, Musgrave Paul, Watt Gordon P, Nader Shahla, Khosla Sundeep, Ambrose Catherine G, McCormick Joseph B, Fisher-Hoch Susan P
Department of Internal Medicine/Division of Geriatric and Palliative Medicine, UTHealth McGovern Medical School, Houston, TX, USA.
Nutritional Biochemistry, Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, USA.
J Osteoporos. 2018 May 13;2018:7153021. doi: 10.1155/2018/7153021. eCollection 2018.
Altered bone quality, caused by underlying metabolic changes of type 2 diabetes (T2D), has been hypothesized to cause altered bone strength and turnover leading to increased fracture risk in T2D patients. Current understanding about changes in bone turnover markers in T2D patients is mainly based on studies focused on Caucasian men and women. However, Hispanic populations have the highest prevalence of both T2D and osteoporosis in the US. We investigated associations of glycemic control (in terms of glycated hemoglobin [HbA1c]) and bone turnover rate in 69 older (≥50 years) Mexican American Cameron County Hispanic Cohort (CCHC) participants with T2D. Multivariable analyses were conducted to assess the associations between HbA1c (%), serum osteocalcin (OC), and serum sclerostin. In agreement with published reports from other racial/ethnic populations, our study found that lower bone turnover (indicated by lower serum OC) occurred in Mexican American men with T2D who had poorer glycemic control. For the women in our study, we found no significant association between glycemic control and OC. In contrast, HbA1c was positively associated with sclerostin for women, with near significance ( = 0.07), while no association was found in men. We recommend screening Mexican American individuals with T2D, specifically those with poor glycemic control, for bone loss and fracture risk.
2型糖尿病（T2D）潜在的代谢变化所导致的骨质量改变，被认为会引起骨强度和骨转换的改变，从而增加T2D患者的骨折风险。目前对T2D患者骨转换标志物变化的认识主要基于针对白种男性和女性的研究。然而，在美国，西班牙裔人群中T2D和骨质疏松症的患病率最高。我们调查了69名年龄较大（≥50岁）的患有T2D的墨西哥裔美国卡梅伦县西班牙裔队列（CCHC）参与者的血糖控制（以糖化血红蛋白[HbA1c]衡量）与骨转换率之间的关联。进行了多变量分析，以评估HbA1c（%）、血清骨钙素（OC）和血清硬化蛋白之间的关联。与其他种族/族裔人群发表的报告一致，我们的研究发现，血糖控制较差的患有T2D的墨西哥裔美国男性骨转换较低（以较低的血清OC表示）。对于我们研究中的女性，我们发现血糖控制与OC之间无显著关联。相比之下，HbA1c与女性的硬化蛋白呈正相关，接近显著水平（P = 0.07），而在男性中未发现关联。我们建议对患有T2D的墨西哥裔美国人，特别是血糖控制较差的人，进行骨质流失和骨折风险筛查。
