Bone Turnover Markers and Adipocytokinesresponse to Weight Reduction among Obese Patients with Type 2 Diabetes Mellitus| Stephy Publishers


SOJ Diabetes and Endocrinology Care - (SOJDEC)| Stephy Publishers

 

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with increased the risk of fracture due to altered bone micro architecture and/or poor quality as key factors. Bone remodeling appears to be impaired among patients with T2DM as both markers of bone formation and markers of bone resorption are decreased when compared to healthy subjects.

Objective: This study aimed to detect if weight reduction modulates adipokines and markers of bone turnover among T2DM patients.

Material and Methods: Eighty obese patients with T2DM (46 men and 34 women), their age ranged from 40-53 years and their body mass index ranged from 30-36 kg/m2 were equally assigned into 2 groups: the weight reduction group received aerobic exercises, diet regimen, where the control group received medical treatment only for 6 months.

Results: The mean values of body mass index (BMI), leptin, resistin, visfatin levels significantly decreased, however the mean values of adiponectin, bone alkaline phosphatase (BAP) and serum cross-linked N-telopeptides of type I collagen (NTX) levels significantly increased in the training group. While, the results of the control group were not significant. In addition, there were significant differences between both groups at the end of the study.

Conclusion: Weight loss ameliorates adipocytokines and bone turnover markers among obese patients with type 2 diabetes mellitus.

Keywords

Aerobic exercise, Bone turnover, Type 2 diabetes mellitus, Adipokines, Diet regimen

Introduction

Globally, Type 2 diabetes mellitus (T2DM) will reach 438 million by 2030.1 Bone damage is a common complication after diabetes mellitus.2,3 Despite there is an evidence that T2DM is related to poor bone quality and micro architecture that elevate the risk of bone fragility and fracture.4

Type 2 diabetes mellitus (T2DM) is a main cause for cardiovascular dysfunctions,5-7 the risk of coronary artery disease is 2-4 times among diabetics than non-diabetics and peripheral vascular diseases risk is ten times greater among diabetics than non-diabetics.8,9

Bone turnover biomarkers (BTMs) indicate the bone remodeling status that includes both bone resorption and formation.9 There an impairment in bone remodeling among patients with diabetes, where bone formation biomarkers and bone resorption biomarkers are reduced.10-13 Although T2DM patients have higher bone marrow density (BMD), the fracture risk is higher among them.14,15 Therefore, BTMs are more sensitive markers than BMD for bone fracture risk, due to possible link between blood glucose metabolism and BTMs.16,17

Bone turnover biomarkers are markers for measure rate of resorption and formation. Osteoblast is responsible for synthesis of bone formation biomarkers, so that reflect certain function of osteoblast18,19 that considered as bone formation markers which are predictors for hip fracture risk and osteoporosis.20-25

The purpose of this study was to determine the effects of weight reduction on bone turnover markers and adipocytokines among obese patients with T2DM.

 

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