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. 2023 Oct 24;5(1):46-55.
doi: 10.1515/almed-2023-0131. eCollection 2024 Mar.

Osteocalcin associates with bone mineral density and VDR gene polymorphisms in type 1 and type 2 diabetes

Carla Ramírez Ruiz  1   2 , Nerea Varo Cenarruzabeitia  3 , Miriam Martínez Villanueva  4 , Antonio M Hernández Martínez  5 , José Antonio Noguera Velasco  5
Affiliations

Osteocalcin associates with bone mineral density and VDR gene polymorphisms in type 1 and type 2 diabetes

Carla Ramírez Ruiz et al. Adv Lab Med. .

Abstract

Objectives: Bone metabolism is impaired in diabetes mellitus (DM). Our objective is to evaluate the association of bone turnover markers (BTM) and vitamin D receptor (VDR) gene polymorphisms with bone mineral density (BMD) in DM type 1 (T1D) and DM type 2 (T2D).

Methods: A total of 165 patients (53 T1D and 112 T2D) were enrolled. BMD was measured by dual-energy X-ray absorptiometry (DEXA). Plasma osteocalcin (OC), beta-CrossLaps (β-CTX) and N-amino terminal propeptide of type I collagen (P1NP) and VDR gene polymorphisms were evaluated.

Results: Participants were 53 T1D (41 years [31-48]) and 112 T2D (60 years [51-66]). BMD were not statistically different between the groups. OC (p<0.001) and P1NP levels (p<0.001) were higher in patients with T1D. The areas under the curve for the prediction of bone pathology were 0.732 (p=0.038) for OC in T1D and 0.697 (p=0.007) in T2D. A significant association was found between lower lumbar BMD and the A allele of BsmI (p=0.03), the A allele of ApaI (p=0.04) and the allele C of the Taql (p=0.046). Also, a significant correlation was found with higher OC levels and the G allele of BsmI (p=0.044), C allele of ApaI (p=0.011), T allele of Taql (p=0.006) and with C allele of FokI (p=0.004).

Conclusions: The high negative predictive value of the cut-off point for OC suggests that could be useful in excluding the risk suffering bone loss, allowing offering a personalized clinical approach to prevent this pathology.

Keywords: VDR polymorphisms; bone; bone turnover markers; diabetes mellitus; osteocalcin; osteoporosis.

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Conflict of interest statement

Competing interests: The authors state no conflict of interest.

Figures

Figure 1:
Figure 1:
Graph shows levels of the bone turnover markers OC (A), β-CTX (B) and P1NP (C) in T1D and T2D in patients with normal bone mineral density compared to patients with bone pathology (osteopenia or osteoporosis) at the time of recruitment. Bars represent mean ± SEM. *p-Values determine significant differences (p<0.05).
Figure 2:
Figure 2:
Graph shows levels of BMD (Lumbar T-score) according to BsmI (A), ApaI (B), and TaqI (C) SNPs in the VDR gene grouped by presence of polymorphic allele. Data are expressed as mean ± SEM. *p-Values determine significant differences (p<0.05).
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