Bone mineral density in relation to metabolic syndrome in postmenopausal women with diabetes type 2

S. Canecki-Varzic; I. Bilic-Curcic

Diabetes type two is associated with greater bone mineral density (BMD) due to obesity although observed rapid bone loss over time could be explained with elevated chronic inflammation. The objective of this study was to investigate the relationship between central adiposity and hyperinsulinaemia as well as inflammation markers with vertebral and femoral BMD and bone turnover markers in postmenopausal women with type two diabetes. Femoral and vertebral BMD, osteocalcin, pyrilinks D, β-CrossLaps (B-CTx), insulin, CRP, fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were measured in 114 female postmenopausal patients with diabetes type two. The patients similar in age, HbA1c levels and diabetes duration were divided in two groups based on their BMI values: lower or equal to 27 (31 patients) and higher than 27 kg/m² (83 patients). The sample means, S.D. and medians were calculated for all variables in each group, whereas t-test as parameter and Mann–Whitney as non-parameter test were used to calculate distribution differences for continuous variables. Spearman’s correlation coefficients were computed to estimate the magnitude of the association between variables of interest. Lower levels of osteocalcin (P=0.001) and B-CTx (P=0.000007) compared to higher femoral BMD (P=0.00006) as well as insulin (P=0.0002), PAI-1 (P=0.000000) and CRP (P=0.002) were found in the overweight group. There were no significant differences in the vertebral BMD, pyrilinks D and fibrinogen. Osteocalcin and B-CTx were inversely correlated, while femoral BMD positively correlated with waist circumference, insulin levels and PAI-1 (Table 1). This suggests that components of the metabolic syndrome, abdominal obesity and hyperinsulinaemia could increase femoral BMD by lowering bone rate. In addition, the only inflammation marker linked with femoral BMD was PAI-1, which is associated with increased mineralization of cortical bone in mouse models.

Spearman’s correlation coefficients for femoral BMD and bone turnover markers versus components of metabolic syndrome.

Table 1
Femoral BMD osteocalcin B-CTx	Waist circumference	Insulin	PAI-1
	R=0.3616 P=0.001	R=0.2981 P=0.005	R=0.345 P=0.001
	R=−0.2693 P=0.011	R=−0.2439 P=0.021	R=−0.2809 P=0.007
	R=−0.3359 P=0.002	R=−0.2239 P=0.037	R=−0.2653 P=0.012

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Endocrine Abstracts

P168