Endocrine Abstracts

Type 2 diabetes mellitus (T2DM) and obesity are linked to osteoporosis, making these patients at increased risk of developing fractures. In this study we aimed to investigate bone biochemical markers and bone structure in diabetic patients to compare with non-diabetic controls.

Methods: We recruited 21 type 2 diabetic patients and 10 non-diabetic controls. Fasting blood samples were collected for markers of bone turnover (Sclerostin (SCL), RANKL, OPG, OPN, OCN, BMP4 and TGF-1β and the inflammatory marker IL-6. Calcaneal bone mineral density (BMD) was measured using a quantitative ultrasound device called Sahara Clinical Bone Sonometer, in which the bare heel is placed in the device and the BMD is calculated within 30 seconds and where the T-score, projected by the device, was used as an indicator of calcaneal BMD.

Results: Patients in the control group were younger and had lower BMI and HbA1c. There was no difference in BMD between groups. OCN was higher in control group, whereas SCL, OPG and IL-6 were raised in the type 2 diabetic group. Furthermore, the type 2 diabetic cohort showed a strong positive correlation between Sclerostin and OPG and IL-6 and RANKL; and a negative correlation between RANKL and OCN and IL-6 and BMP-4.

Conclusions: Fracture risk in diabetes may be mediated by modulation of bone-related proteins. Although BMD showed no difference in bone structure between diabetic patients and controls, the alteration detected in osteogenic factors could reflect the increased risk of vascular calcification present in diabetic patients. This will be investigated in future studies.