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. 2017 Jul 4:5:17020.
doi: 10.1038/boneres.2017.20. eCollection 2017.

The association between the baseline bone resorption marker CTX and incident dysglycemia after 4 years

Ting-Ting Liu  1 , Dong-Mei Liu  1 , Yan Xuan  1   2 , Lin Zhao  1   3 , Li-Hao Sun  1 , Dian-Dian Zhao  1 , Xiao-Feng Wang  1 , Yang He  1 , Xing-Zhi Guo  1 , Rui Du  1 , Ji-Qiu Wang  1 , Jian-Min Liu  1 , Hong-Yan Zhao  1 , Bei Tao  1
Affiliations

The association between the baseline bone resorption marker CTX and incident dysglycemia after 4 years

Ting-Ting Liu et al. Bone Res. .

Abstract

Bone is an endocrine organ involved in modulating glucose homeostasis. The role of the bone formation marker osteocalcin (OCN) in predicting diabetes was reported, but with conflicting results. No study has explored the association between baseline bone resorption activity and incident diabetes or prediabetes during follow-up. Our objective was to examine the relationship between the baseline bone resorption marker crosslinked C-telopeptide of type I collagen (CTX) and glycemic dysregulation after 4 years. This longitudinal study was conducted in a university teaching hospital. A total of 195 normal glucose tolerant (NGT) women at baseline were invited for follow-up. The incidence of diabetes and prediabetes (collectively defined as dysglycemia) was recorded. A total of 128 individuals completed the 4-year study. The overall conversion rate from NGT to dysglycemia was 31.3%. The incidence of dysglycemia was lowest in the middle tertile [16.3% (95% confidence interval (CI), 6.8%-30.7%)] compared with the lower [31.0% (95% CI, 17.2%-46.1%)] and upper [46.5% (95% CI, 31.2%-62.6%)] tertiles of CTX, with a significant difference seen between the middle and upper tertiles (P=0.002 5). After adjusting for multiple confounding variables, the upper tertile of baseline CTX was associated with an increased risk of incident dysglycemia, with an odds ratio of 7.09 (95% CI, 1.73-28.99) when the middle tertile was the reference. Osteoclasts actively regulate glucose homeostasis in a biphasic model that moderately enhanced bone resorption marker CTX at baseline provides protective effects against the deterioration of glucose metabolism, whereas an overactive osteoclastic function contributes to an increased risk of subsequent dysglycemia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
HbA1c at the follow-up according to baseline CTX tertiles. Data are shown as the mean (minimum, maximum). *P<0.05, **P<0.01.
Figure 2
Figure 2
Incidence of dysglycemia at the follow-up according to baseline CTX tertiles. Data are shown as the mean (95% CIs). **P<0.01.
See this image and copyright information in PMC

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