PARAMETERS OF BONE METABOLISM IN PRE-AND POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS IN THE RATIONALE FOR THE CHOICE OF ANTIOSTEOPOROTIC THERAPY
Abstract
Introduction. Bone health in type 2 diabetes mellitus (T2DM) is discussed for a long time as a known fact for increased risk of fractures. Purpose. To estimate the parameters of bone remodeling in pre-andpostmenopausal women with T2DM. Materials and Methods. In a cross-sectional pilot study which included 80 women: 40 with T2DM and 40 without disturbances of glucose metabolism (K), divided into subgroups of premenopausal (pre) and natural menopause (post) — 20 patients each. Results and conclusions. We found a tendency toward a decrease in bone turnover in patients T2DM, a significant negative relationship with C-peptide and ALP in T2DM, a positive correlation with tartrate — resistant acid phosphatase in the control group, although the levels of C-peptide did not differ in patients with T2DM and in the control group . Identified characteristics of decreased bone remodeling in patients with T2DM pathogenically justify the use of anabolic antiosteoporotic drugs for treatment of osteoporosis in such patients.
References
1. Brandy M.L. Bone health and diabetes.-Medocographia. — 2010. — Vol.32, No.4. — p.364—367.
2. Руяткина Л.А., Ломова А.В., Руяткин Д.С. Состояние костной ткани при сахарном диабете 2 типа.-Фармотека. — 2013. — №5. — c.25—31.
3. Kanis J. A., McCloskey E. V., Johansson H., Cooper C., Rizzoli R., Reginster J.-Y. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. — Osteoporos Int. —2013. — No.24(1). —p.23—57.
4. Сандерс Л.Р. Гиперпаратиреоз в кн.: МакДермот М. Секреты эндокринологии. 4-е изд., исправ. и дополн./Пер. с англ. И.:Издательство БИНОМ, 2010. — с.175—184.
5. Flynn CA. Calcium supplementation in postmenopausal women. Am Fam Physician 2004; 69 (12): 2822—3.
6. Need AG, Metz M, O’Loughlin PD et al. Calcium absorbtion in hip fractures subjects. J Bone Miner Res 2004.
7. Остеопороз. Диагностика, профилактика и лечение. Клинические рекомендации / Под. ред. О. М. Лесняк, Л. И. Беневоленской. М.: «ГЭОТАР-Медиа», 2010.
8. Montagnani А. Osteoporosis treatment in diabetic patients: what’s different? Ital J Med 2012; 6:97 17th National Congress of the FADOI, Rimini, Italy.
9. Yamamoto M, Yamaguchi T, Nawata K, Yamauchi M, Sugimoto T. Decreased PTH levels accompanied by low bone formation are associated with vertebral fractures in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab. 2012 Apr;97(4):1277—84.
10. Iglesias P, Arrieta F, Pinera M, Botella-Carretero JI, Balsa JA, Zamarrón I, Menacho M, Diez JJ, Munoz T, Vazquez C. Serum concentrations of osteocalcin, procollagen type 1 N-terminal propeptide and beta-CrossLaps in obese subjects with varying degrees of glucose tolerance. Clin Endocrinol (Oxf). 2011 Aug;75(2): 184—8. Shu A, Yin MT, Stein E, Cremers S, Dworakowski E, Ives R, Rubin MR. Bone structure and turnover in type 2 diabetes mellitus. Osteoporos Int. 2012 Feb;23(2):635—41.
11. Kanazawa I, Yamaguchi T, Yamamoto M, Yamauchi M, Kurioka S, Yano S, Sugimoto T. Serum osteocalcin level is associated with glucose metabolism and atherosclerosis parameters in type 2 diabetes mellitus. J Clin Endocrinol Metab. 2009 Jan;94(1):45—9.
12. Hwang YC, Jeong IK, Ahn KJ, Chung HY. Circulating osteocalcin level is associated with improved glucose tolerance, insulin secretion and sensitivity independent of the plasma adiponectin level. Osteoporos Int. 2012 Apr;23(4):1337—42.
13. Lieben L, Callewaert F, Bouillon R. Bone and metabolism: a complex crosstalk.Horm Res. 2009;71(suppl 1):134—138.
14. Григорян О.Р., Андреева Е.Н. Менопаузальный синдром у женщин с нарушениями углеводного обмена. Альтернативные и дополнительные методы терапии в климктерии (обзор литературы) // Гинекология. — 2011. — №3. — С.4—7.
15. Okazaki R, Totsuka Y, Hamano K, Ajima M, Miura M, Hirota Y, Hata K, Fukumoto S, Matsumoto T. Metabolic improvement of poorly controlled noninsulin-dependent diabetes mellitus decreases bone turnover. J Clin Endocrinol Metab. 1997 Sep;82(9):2915—20.
16. Rosato MT, Schneider SH, Shapses SA. Bone turnover and insulin-like growth factor I levels increase after improved glycemic control in noninsulin-dependent diabetes mellitus. Calcif Tissue Int. 1998 Aug;63(2):107—11.
17. Garcia R.R., Gimeno E.J., Martin A.G. et al. Clinical practice guidelines for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions (CONSENSUS DOCUMENT). Endocrinol.Nutr., 2012; 59 (3): 174—196.
18. Дедов И. И., Шестакова М. В. (ред.). Алгоритмы специализированной медицинской помощи больным сахарным диабетом. М.; 2011.
19. Miazgowski T, Noworyta-Ziętara M, Safranow K, Ziemak J, Widecka K. Serum adiponectin, bone mineral density and bone turnover markers in post-menopausal women with newly diagnosed Type 2 diabetes: a 12-month follow-up. Diabet Med. 2012 Jan;29(1):62—9.
20. Saito J, Nishikawa T. [Osteoporosis treatment in patients with hyperthyroidism]. Nihon Rinsho. 2009 May;67(5):1011—
21. Review. Japanese.
22. Meunier PJ, Roux C, Seeman E, Ortolani S, Badurski JE, Spector TD, Cannata J, Balogh A, Lemmel EM, PorsNielsen S, Rizzoli R, Genant HK, Reginster JY. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004 Jan 29;350(5):459—68.
23. Reginster J-Y, Kaufman J-M., Goemaere S. et al. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int. 2012 March; 23(3): 1115—1122.
24. Lunar L.J., Brakamonte M.A., Serafin M.E. et al. Comparison of change in bone resorption and bone mineral density with onceweekly alendronate and daily strontium ranelate: a randomized, placebo-controlled study. Osteoporos Int (2012). v.23: (Suppl 2): S185.
25. Yalin S., Sagÿ O., Comelekoglu U. et al. Strontium ranelate treatment improves oxidative damage in osteoporotic rat model. Pharmacological Reports 2011; 63; 396—402.
26. Ceriello A., Ihnat M.A., Thorpe J.E. The “Metabolic Memory”: Is More Than Just Tight Glucose Control Necessary to Prevent Diabetic Complications? J Clin Endocrinol Metabol 2009;94:410-15.
27. Fernandez JM, Molinuevo MS , Schurman L, Sedlinsky C, McCarthy AD. Strontium ranelate prevents the deleterious action of advanced glycation end products on bone marrow progenitor cells via activation of WNT pathway. Arch Osteoporos (2012) 7 (Suppl 1):S153—S204
Review
For citations:
Ruyatkina L.A., Lomova A.V., Ruyatkin D.S., Romanov V.V. PARAMETERS OF BONE METABOLISM IN PRE-AND POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS IN THE RATIONALE FOR THE CHOICE OF ANTIOSTEOPOROTIC THERAPY. Osteoporosis and Bone Diseases. 2013;16(3):8-12. (In Russ.)
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