title: Serum osteocalcin/bone-specific alkaline phosphatase ratio is a predictor for the presence of vertebral fractures in men with type 2 diabetes.
abstract: We examined whether or not BMD or bone markers were useful for assessing the risk of vertebral fractures in 248 Japanese men with type 2 diabetes. We analyzed the relationships between bone markers (osteocalcin [OC], bone-specific alkaline phosphatase [BAP], urinary N-terminal cross-linked telopeptide of type-I collagen) or BMD and HbA(1c), urinary C-peptide, insulin-like growth factor-I (IGF-I), parathyroid hormone, 1,25(OH)(2) vitamin D, and the presence of prevalent vertebral fractures. Multiple regression analysis adjusted for age, body height, weight, duration of diabetes, and serum creatinine showed that serum OC and OC/BAP ratio were correlated negatively with HbA(1c) (P < 0.01) and positively with IGF-I (P < 0.01). Multivariate logistic regression analysis adjusted for the above parameters showed that serum OC/BAP ratio was inversely associated with the presence of vertebral fractures (odds ratio = 0.695, P < 0.05). This association was still significant after additional adjustment for lumbar or femoral neck BMD. Our results suggest that poor diabetic control and lower IGF-I level are linked to impaired bone formation and resultant reduction in OC/BAP ratio in men with type 2 diabetes. The OC/BAP ratio could be clinically useful for assessing the risk of vertebral fractures independent of BMD in diabetic men.
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan. ippei.k@med.shimane-u.ac.jp
authors.forename: Ippei
authors.initials: I
authors.lastname: Kanazawa
authors.forename: Toru
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Mika
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Shozo
authors.initials: S
authors.lastname: Yano
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000032:analysis / Q000097:blood*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D015519:Bone Density / Q000502:physiology; D001861:Bone Regeneration / Q000502:physiology; D002117:Calcitriol / Q000032:analysis; D048909:Diabetes Complications / Q000097:blood* / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000032:analysis / Q000097:blood*; D010281:Parathyroid Hormone / Q000032:analysis; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000097:blood* / Q000175:diagnosis*; D013131:Spine / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: D000469:Alkaline Phosphatase; D015415:Biomarkers; D002117:Calcitriol; D006442:Glycated Hemoglobin; D007334:Insulin-Like Growth Factor I; D015675:Osteocalcin; D010281:Parathyroid Hormone; C517652:hemoglobin A1c protein, human