title: CTX (crosslaps) rather than osteopontin is associated with disturbed glucose metabolism in gestational diabetes.
abstract: OBJECTIVE
  Reciprocal interaction between bone and glucose metabolism might play a pivotal role in the development of type 2 diabetes. We recently demonstrated that osteocalcin is increased in women with gestational diabetes (GDM) compared to healthy pregnant women and related to enhanced insulin secretion. Here, we aimed to investigate the role of the bone resorption marker CTX and osteopontin (OPN), a key molecule in subclinical inflammation underlying insulin resistance, in gestational diabetes.
  
  
  METHODS
  Insulin sensitivity and secretion (derived from OGTT) as well as CTX and osteopontin were investigated in 26 GDM and 52 women with normal glucose tolerance during pregnancy [CON] between 24th and 28th gestational weeks; 24 women also underwent postpartum examination.
  
  
  RESULTS
  CTX was significantly higher in GDM compared to CON (0.44±0.20 vs.0.28±0.12 ng/ml, p<.0001) and positively correlated with osteocalcin (R = 0.64, p<.0001) and parameters of insulin secretion. Osteopontin plasma concentrations were decreased in GDM compared to CON (28.81±22.12 vs.37.68±19.63 ng/ml, p = 0.04), and did not show any relation to insulin secretion or sensitivity, but were significantly correlated with CRP (R = 0.3, p<0.007) and liver enzymes. Twelve weeks after delivery CTX and OPN were increased compared to pregnancy (both p<.0001) and did not differ between GDM and CON.
  
  
  CONCLUSIONS
  Our findings support the idea of a tight regulation between bone and glucose metabolism, and suggest, that less curbed CTX during pregnancy might be involved in osteocalcin-mediated amelioration of insulin secretion in GDM. On the other hand, osteopontin was unrelated to insulin resistance in GDM, but associated with inflammatory markers and liver enzymes in all women.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors: Yvonne
authors: Y
authors: Winhofer
authors: Florian W
authors: FW
authors: Kiefer
authors: Ammon
authors: A
authors: Handisurya
authors: Andrea
authors: A
authors: Tura
authors: Katharina
authors: K
authors: Klein
authors: Barbara
authors: B
authors: Schneider
authors: Rodrig
authors: R
authors: Marculescu
authors: Oswald F
authors: OF
authors: Wagner
authors: Giovanni
authors: G
authors: Pacini
authors: Anton
authors: A
authors: Luger
authors: Thomas M
authors: TM
authors: Stulnig
authors: Alexandra
authors: A
authors: Kautzky-Willer
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001862:Bone Resorption / Q000097:blood; D016022:Case-Control Studies; D003094:Collagen / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D053495:Osteopontin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D053495:Osteopontin; D003094:Collagen