Ramírez Ruiz Carla, Varo Cenarruzabeitia Nerea, Martínez Villanueva Miriam, Hernández Martínez Antonio M, Noguera Velasco José Antonio
Department of Clinical Biochemistry, Clínica Universidad de Navarra, Madrid, Spain.
Servicio de Bioquímica, Clínica Universidad de Navarra - Madrid, Madrid, Spain.
Adv Lab Med. 2023 Oct 24;5(1):46-55. doi: 10.1515/almed-2023-0131. eCollection 2024 Mar.
Bone metabolism is impaired in diabetes mellitus (DM). Our objective is to evaluate the association of bone turnover markers (BTM) and vitamin D receptor () gene polymorphisms with bone mineral density (BMD) in DM type 1 (T1D) and DM type 2 (T2D).
A total of 165 patients (53 T1D and 112 T2D) were enrolled. BMD was measured by dual-energy X-ray absorptiometry (DEXA). Plasma osteocalcin (OC), beta-CrossLaps (β-CTX) and N-amino terminal propeptide of type I collagen (P1NP) and gene polymorphisms were evaluated.
Participants were 53 T1D (41 years [31-48]) and 112 T2D (60 years [51-66]). BMD were not statistically different between the groups. OC (p<0.001) and P1NP levels (p<0.001) were higher in patients with T1D. The areas under the curve for the prediction of bone pathology were 0.732 (p=0.038) for OC in T1D and 0.697 (p=0.007) in T2D. A significant association was found between lower lumbar BMD and the A allele of (p=0.03), the A allele of (p=0.04) and the allele C of the (p=0.046). Also, a significant correlation was found with higher OC levels and the G allele of (p=0.044), C allele of (p=0.011), T allele of (p=0.006) and with C allele of (p=0.004).
The high negative predictive value of the cut-off point for OC suggests that could be useful in excluding the risk suffering bone loss, allowing offering a personalized clinical approach to prevent this pathology.
糖尿病（DM）患者存在骨代谢受损情况。我们的目的是评估骨转换标志物（BTM）和维生素D受体（）基因多态性与1型糖尿病（T1D）和2型糖尿病（T2D）患者骨密度（BMD）之间的关联。
共纳入165例患者（53例T1D和112例T2D）。采用双能X线吸收法（DEXA）测量骨密度。评估血浆骨钙素（OC）、β-交联C端肽（β-CTX）和I型胶原N端前肽（P1NP）以及基因多态性。
参与者包括53例T1D（41岁[31 - 48岁]）和112例T2D（60岁[51 - 66岁]）。两组之间的骨密度无统计学差异。T1D患者的OC水平（p<0.001）和P1NP水平（p<0.001）较高。T1D中OC预测骨病理的曲线下面积为0.732（p = 0.038），T2D中为0.697（p = 0.007）。发现腰椎骨密度降低与（p = 0.03）的A等位基因、（p = 0.04）的A等位基因以及（p = 0.046）的C等位基因之间存在显著关联。此外，还发现较高的OC水平与（p = 0.044）的G等位基因、（p = 0.011）的C等位基因、（p = 0.006）的T等位基因以及（p = 0.004）的C等位基因之间存在显著相关性。
OC切点的高阴性预测价值表明，其可能有助于排除骨质流失风险，从而为预防这种病理情况提供个性化的临床方法。
