Accumulating evidence suggests that patients with low bone mineral density (BMD) have an increased risk of developing cardiovascular disease, and that both conditions share common cardio-metabolic risk factors (e.g., diabetes, obesity, chronic kidney disease, smoking, chronic inflammation) [1,2]. Preliminary inconclusive data also suggest the existence of a significant association between subclinical atherosclerosis and either low BMD [3,4] or abnormal levels of some indirect bone turnover biomarkers in patients with or without type 2 diabetes mellitus (T2DM) [5-7]. In this exploratory cross-sectional study, we recruited 83 Italian post-menopausal women with non-insulin-treated T2DM (mean ± SD age: 71.5±8 years; diabetes duration: 12.9±9 years; body mass index [BMI]: 29.6±4 kg/m2; HbA1c: 52±8 mmol/mol), who consecutively attended our diabetes outpatient service of the Division of Endocrinology and Metabolism of the University of Verona during a period of 3 months. We excluded patients with chronic liver diseases, cancer, kidney failure, overt dysthyroidism as well as those treated with hormone replacement therapy, steroids or anti-osteoporotic drugs. In all patients, we measured serum levels of 25-hydroxyvitamin D3 [25(OH)D], high sensitivity C-reactive protein (hs-CRP), estimated glomerular filtration rate (e-GFR as estimated using the CKD-Epidemiology Collaboration equation), calcium, phosphorus, parathyroid hormone and multiple bone turnover biomarkers (i.e., C-terminal telopeptide of type 1 collagen [sCTX], periostin, sclerostin, procollagen type 1 N-terminal propeptide [P1NP], dickkopf-related protein-1 [DKK-1], and receptor activator of nuclear factor-kB ligand [RANKL]). Measurements of common carotid-artery intima-media thickness (IMT) and carotid plaques were also performed (using a Doppler ultrasonography) by an expert operator, who was blinded to patients’ clinical and biochemical details. A dual energy X-ray absorptiometry (DEXA) scan was also performed using the GE Lunar iDXA system (GE Healthcare Lunar, Madison, WI, USA). The axial densitometry was performed to obtain BMD measurements at the level of both lumbar spine and femur.
Association between increased carotid intima-media thickness and higher serum C-terminal telopeptide of type 1 collagen levels in post-menopausal women with type 2 diabetes
Mantovani, A;Altomari, A;Fassio, A;Gatti, D;Targher, G
2020-01-01
Abstract
Accumulating evidence suggests that patients with low bone mineral density (BMD) have an increased risk of developing cardiovascular disease, and that both conditions share common cardio-metabolic risk factors (e.g., diabetes, obesity, chronic kidney disease, smoking, chronic inflammation) [1,2]. Preliminary inconclusive data also suggest the existence of a significant association between subclinical atherosclerosis and either low BMD [3,4] or abnormal levels of some indirect bone turnover biomarkers in patients with or without type 2 diabetes mellitus (T2DM) [5-7]. In this exploratory cross-sectional study, we recruited 83 Italian post-menopausal women with non-insulin-treated T2DM (mean ± SD age: 71.5±8 years; diabetes duration: 12.9±9 years; body mass index [BMI]: 29.6±4 kg/m2; HbA1c: 52±8 mmol/mol), who consecutively attended our diabetes outpatient service of the Division of Endocrinology and Metabolism of the University of Verona during a period of 3 months. We excluded patients with chronic liver diseases, cancer, kidney failure, overt dysthyroidism as well as those treated with hormone replacement therapy, steroids or anti-osteoporotic drugs. In all patients, we measured serum levels of 25-hydroxyvitamin D3 [25(OH)D], high sensitivity C-reactive protein (hs-CRP), estimated glomerular filtration rate (e-GFR as estimated using the CKD-Epidemiology Collaboration equation), calcium, phosphorus, parathyroid hormone and multiple bone turnover biomarkers (i.e., C-terminal telopeptide of type 1 collagen [sCTX], periostin, sclerostin, procollagen type 1 N-terminal propeptide [P1NP], dickkopf-related protein-1 [DKK-1], and receptor activator of nuclear factor-kB ligand [RANKL]). Measurements of common carotid-artery intima-media thickness (IMT) and carotid plaques were also performed (using a Doppler ultrasonography) by an expert operator, who was blinded to patients’ clinical and biochemical details. A dual energy X-ray absorptiometry (DEXA) scan was also performed using the GE Lunar iDXA system (GE Healthcare Lunar, Madison, WI, USA). The axial densitometry was performed to obtain BMD measurements at the level of both lumbar spine and femur.
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