This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okazaki, R. Articles by Matsumoto, T. Search for Related Content PubMed PubMed Citation Articles by Okazaki, R. Articles by Matsumoto, T.

Metabolic Improvement of Poorly Controlled Noninsulin-Dependent Diabetes Mellitus Decreases Bone Turnover¹

Department of Metabolism and Endocrinology (R.O., Y.T., K.H., M.A.), Kanto Teishin Hospital; Mitsubishi Kagaku Bioclinical Laboratories, Inc. (M.M., Y.H., K.H.); Fourth Department of Internal Medicine (S.F.), University of Tokyo School of Medicine, Tokyo; First Department of Internal Medicine (T.M.), University of Tokushima School of Medicine, Tokushima, Japan

Address correspondence and requests for reprints to: Ryo Okazaki, M.D. Third Department of Medicine, Teikyo University School of Medicine, 3426–3 Anesaki, Ichihara-city, Chiba 299–01, Japan.

Patients with poorly controlled noninsulin dependent diabetes mellitus (NIDDM) are shown to have higher bone mass. However, the influence of changes in glycemic control on bone turnover is not known. To clarify whether metabolic improvement of poorly controlled NIDDM affects bone turnover, markers for glucose, mineral, and bone metabolism were assessed before and after glycemic control for 3 weeks in 78 poorly controlled NIDDM patients with initial hemoglobin A1c over 8%. Metabolic improvement caused a reduction in urinary calcium (Ca) and phosphate (Pi) and serum 1,25(OH)₂D levels, and an increase in serum Pi without changes in serum Ca or parathyroid hormone levels. Bone resorption markers, urinary deoxypyridinoline (Dpd) and type I collagen carboxy-terminal telopeptide (CTx), as well as a bone formation marker, serum bone type alkaline phosphatase (BALP), were reduced. However, another bone formation marker, serum osteocalcin (OC), was low before treatment and was elevated after treatment. The decrease in Dpd, CTx and BALP, but not the increase in OC, correlated with each other and with the improvement in glycemic indices. In conclusion, metabolic improvement of poorly controlled NIDDM decreases bone turnover within a short period. Thus, glycemic control may protect NIDDM patients from bone loss. It is possible that serum OC is affected by hyperglycemia per se, and may not correctly reflect bone turnover.

This article has been cited by other articles:

				B. Tao, J.-M. Liu, H.-Y. Zhao, L.-H. Sun, W.-Q. Wang, X.-Y. Li, and G. Ning Differences between Measurements of Bone Mineral Densities by Quantitative Ultrasound and Dual-Energy X-Ray Absorptiometry in Type 2 Diabetic Postmenopausal Women J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1670 - 1675. [Abstract] [Full Text] [PDF]

				C. E Murphy and P. T Rodgers Effects of Thiazolidinediones on Bone Loss and Fracture Ann. Pharmacother., December 1, 2007; 41(12): 2014 - 2018. [Abstract] [Full Text] [PDF]

				T. Sugiyama, T. Takaki, K. Sakanaka, H. Sadamaru, K. Mori, Y. Kato, T. Taguchi, and T. Saito Warfarin-induced impairment of cortical bone material quality and compensatory adaptation of cortical bone structure to mechanical stimuli J. Endocrinol., July 1, 2007; 194(1): 213 - 222. [Abstract] [Full Text] [PDF]

				A. Grey, M. Bolland, G. Gamble, D. Wattie, A. Horne, J. Davidson, and I. R. Reid The Peroxisome Proliferator-Activated Receptor-{gamma} Agonist Rosiglitazone Decreases Bone Formation and Bone Mineral Density in Healthy Postmenopausal Women: A Randomized, Controlled Trial J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1305 - 1310. [Abstract] [Full Text] [PDF]

				S. A. Brown and J. L. Sharpless Osteoporosis: An Under-appreciated Complication of Diabetes Clin. Diabetes, January 1, 2004; 22(1): 10 - 20. [Abstract] [Full Text] [PDF]

				D. L. Chau, J. Goldstein-Fuchs, and S. V. Edelman Osteoporosis Among Patients With Diabetes: An Overlooked Disease Diabetes Spectr, July 1, 2003; 16(3): 176 - 182. [Abstract] [Full Text] [PDF]

				R. Okazaki, M. Toriumi, S. Fukumoto, M. Miyamoto, T. Fujita, K. Tanaka, and Y. Takeuchi Thiazolidinediones Inhibit Osteoclast-Like Cell Formation and Bone Resorption in Vitro Endocrinology, November 1, 1999; 140(11): 5060 - 5065. [Abstract] [Full Text]