Alterations in serum levels of 1 alpha,25(OH)2 D3 and osteocalcin in patients with early diabetic nephropathy.
Serum levels of markers for bone remodeling and diabetic metabolic markers were measured in subjects with non-insulin-dependent diabetes mellitus (NIDDM) to investigate the relationship between early diabetic nephropathy and calcium/bone metabolism. 1 alpha,25(OH)2 D3 (Vit D), osteocalcin (OC), intact parathyroid hormone (PTH) and urine albumin excretion (UAE) were measured in all subjects. Serum levels of Vit D and OC were significantly decreased in diabetic subjects compared to age-matched, non-diabetic controls. In diabetic patients, a significant positive correlation was observed between intact PTH and OC. No significant correlation was found between levels of Vit D and OC. In early diabetic nephropathy without increased serum creatinine, Vit D decreased and OC increased with increasing UAE. Levels of hemoglobin Alc (HbAlc) and fructosamine (FRA) were not correlated with levels of Vit D or OC. Levels of Vit D were decreased and levels of OC were increased in diabetic subjects with proliferative retinopathy or with micro- or macro-albuminuria.


CONCLUSIONS
Results of the present study indicate that changes in bone remodeling markers such as Vit D and OC levels are present in the early stages of diabetic nephropathy, and that circulating intact PTH is important in restoring the reduced OC levels in diabetic patients, probably as a reflection of bone remodeling.
Inukai
T
T
Department of Medicine, Dokkyo University School of Medicine, Koshigaya Hospital, Japan.
Fujiwara
Y
Y
Tayama
K
K
Aso
Y
Y
Takemura
Y
Y
D000419:Albuminuria / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002117:Calcitriol / Q000097:blood*; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D003928:Diabetic Nephropathies / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D010281:Parathyroid Hormone / Q000097:blood; D012709:Serum Albumin / Q000378:metabolism
D015415:Biomarkers; D010281:Parathyroid Hormone; D012709:Serum Albumin; D015675:Osteocalcin; D003404:Creatinine; D002117:Calcitriol; D002118:Calcium