Glucose variability and low bone turnover in people with type 2 diabetes

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Glucose variability and low bone turnover in people with type 2 diabetes. / Starup-Linde, Jakob; Lykkeboe, Simon; Handberg, Aase; Vestergaard, Peter; Høyem, Pernille; Fleischer, Jesper; Hansen, Troels Krarup; Poulsen, Per Løgstrup; Laugesen, Esben.

In: Bone, Vol. 153, 116159, 12.2021.

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@article{1886af3f69d44a20937b1da56ed8d526,
title = "Glucose variability and low bone turnover in people with type 2 diabetes",
abstract = "INTRODUCTION: Type 2 diabetes (T2D) is related to an increased fracture risk and low bone turnover. However, the mechanisms are not elucidated. In the present study we investigate the association between glycemic variability and bone turnover markers.METHODS: 100 participants with T2D and 100 age and gender matched controls were included in this cross-sectional study. All participants with T2D were equipped with a continuous glucose monitoring (CGM) sensor for 3 days (CGMS iPro Continuous Glucose Recorder; Medtronic MiniMed). The dawn glucose levels were defined as a morning period starting 1 h before breakfast ending 1 h post ingestion. On all participants serum (s)-C-terminal cross-linked telopeptide of type-I collagen (CTX), s-procollagen type 1 amino terminal propeptide (P1NP), and s-sclerostin were measured.RESULTS: Participants with T2D displayed significantly lower levels of the bone resorption marker s-CTX and the bone formation marker s-P1NP compared to controls. S-CTX was significantly negatively associated with the mean amplitude of glycemic excursions (MAGE) and the dawn glucose levels whereas s-P1NP only was significantly negatively associated with the dawn glucose levels while it was borderline significantly associated with MAGE (p=0.05). S-CTX and s-P1NP were significantly lower among the 50 % with the highest dawn glucose levels compared to the 50 % lowest dawn glucose levels also after adjustment for age, gender, glycated hemoglobin A1c (HbA1c), and body mass index (BMI).CONCLUSION: We observed that the amplitude of glycemic excursions and rise in dawn glucose was negatively associated with bone turnover markers. Future research is needed to determine whether reduction of the amplitude of glycemic excursions increase bone turnover markers.",
keywords = "Bone turnover, Diabetes, Glycemic variability, Sclerostin",
author = "Jakob Starup-Linde and Simon Lykkeboe and Aase Handberg and Peter Vestergaard and Pernille H{\o}yem and Jesper Fleischer and Hansen, {Troels Krarup} and Poulsen, {Per L{\o}gstrup} and Esben Laugesen",
year = "2021",
month = dec,
doi = "10.1016/j.bone.2021.116159",
language = "English",
volume = "153",
journal = "Bone",
issn = "8756-3282",
publisher = "Elsevier Inc.",

}

RIS

TY - JOUR

T1 - Glucose variability and low bone turnover in people with type 2 diabetes

AU - Starup-Linde, Jakob

AU - Lykkeboe, Simon

AU - Handberg, Aase

AU - Vestergaard, Peter

AU - Høyem, Pernille

AU - Fleischer, Jesper

AU - Hansen, Troels Krarup

AU - Poulsen, Per Løgstrup

AU - Laugesen, Esben

PY - 2021/12

Y1 - 2021/12

N2 - INTRODUCTION: Type 2 diabetes (T2D) is related to an increased fracture risk and low bone turnover. However, the mechanisms are not elucidated. In the present study we investigate the association between glycemic variability and bone turnover markers.METHODS: 100 participants with T2D and 100 age and gender matched controls were included in this cross-sectional study. All participants with T2D were equipped with a continuous glucose monitoring (CGM) sensor for 3 days (CGMS iPro Continuous Glucose Recorder; Medtronic MiniMed). The dawn glucose levels were defined as a morning period starting 1 h before breakfast ending 1 h post ingestion. On all participants serum (s)-C-terminal cross-linked telopeptide of type-I collagen (CTX), s-procollagen type 1 amino terminal propeptide (P1NP), and s-sclerostin were measured.RESULTS: Participants with T2D displayed significantly lower levels of the bone resorption marker s-CTX and the bone formation marker s-P1NP compared to controls. S-CTX was significantly negatively associated with the mean amplitude of glycemic excursions (MAGE) and the dawn glucose levels whereas s-P1NP only was significantly negatively associated with the dawn glucose levels while it was borderline significantly associated with MAGE (p=0.05). S-CTX and s-P1NP were significantly lower among the 50 % with the highest dawn glucose levels compared to the 50 % lowest dawn glucose levels also after adjustment for age, gender, glycated hemoglobin A1c (HbA1c), and body mass index (BMI).CONCLUSION: We observed that the amplitude of glycemic excursions and rise in dawn glucose was negatively associated with bone turnover markers. Future research is needed to determine whether reduction of the amplitude of glycemic excursions increase bone turnover markers.

AB - INTRODUCTION: Type 2 diabetes (T2D) is related to an increased fracture risk and low bone turnover. However, the mechanisms are not elucidated. In the present study we investigate the association between glycemic variability and bone turnover markers.METHODS: 100 participants with T2D and 100 age and gender matched controls were included in this cross-sectional study. All participants with T2D were equipped with a continuous glucose monitoring (CGM) sensor for 3 days (CGMS iPro Continuous Glucose Recorder; Medtronic MiniMed). The dawn glucose levels were defined as a morning period starting 1 h before breakfast ending 1 h post ingestion. On all participants serum (s)-C-terminal cross-linked telopeptide of type-I collagen (CTX), s-procollagen type 1 amino terminal propeptide (P1NP), and s-sclerostin were measured.RESULTS: Participants with T2D displayed significantly lower levels of the bone resorption marker s-CTX and the bone formation marker s-P1NP compared to controls. S-CTX was significantly negatively associated with the mean amplitude of glycemic excursions (MAGE) and the dawn glucose levels whereas s-P1NP only was significantly negatively associated with the dawn glucose levels while it was borderline significantly associated with MAGE (p=0.05). S-CTX and s-P1NP were significantly lower among the 50 % with the highest dawn glucose levels compared to the 50 % lowest dawn glucose levels also after adjustment for age, gender, glycated hemoglobin A1c (HbA1c), and body mass index (BMI).CONCLUSION: We observed that the amplitude of glycemic excursions and rise in dawn glucose was negatively associated with bone turnover markers. Future research is needed to determine whether reduction of the amplitude of glycemic excursions increase bone turnover markers.

KW - Bone turnover

KW - Diabetes

KW - Glycemic variability

KW - Sclerostin

UR - http://www.scopus.com/inward/record.url?scp=85114157469&partnerID=8YFLogxK

U2 - 10.1016/j.bone.2021.116159

DO - 10.1016/j.bone.2021.116159

M3 - Journal article

C2 - 34461287

VL - 153

JO - Bone

JF - Bone

SN - 8756-3282

M1 - 116159

ER -