title: The effects of diabetes mellitus and diabetic nephropathy on bone and mineral metabolism in T2DM patients.
abstract: OBJECTIVE
  To assess the effects of both diabetes mellitus and diabetic nephropathy on bone mineral metabolism in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Serum osteocalcin (BGP), serum alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BAP), 24-h urinary hydroxyproline (HOP), blood and urine calcium (Ca), phosphate (P) levels and bone mineral density (BMD) were assessed and compared in 30 patients with T2DM (group D), 25 T2DM patients with nephropathy (group DN) and 27 nondiabetic control subjects (group C).
  
  
  RESULTS
  Compared with the nondiabetic controls, patients in both groups D and DN had decreased serum osteocalcin (BGP) and bone mineral density (BMD) while serum alkaline phosphatase (ALP) and urinary hydroxyproline (HOP) were increased. Decrease in BGP was not correlated with ALP (r = -0.1, P<0.37). Within both diabetes groups (group D and group DN), no significant change in BAP is observed, however group DN showed higher level of BGP, higher level of HOP and lower BMD than group D. Urine calcium was increased in both group D and DN with group D having higher levels than group DN. In DN patients had increased circulating phosphate and decreased urinary excretion of phosphate, while decreased circulating phosphate and increased urinary excretion phosphate are seen in group D patients.
  
  
  CONCLUSIONS
  Patients with T2DM show an imbalance of bone mineral metabolism, and co-existence of nephropathy tends to aggravate this. Serum osteocalcin and 24-h hydroxyproline may be considered useful biochemical markers for monitoring possible bone mineral metabolism disorder in T2DM patients.
authors.affiliation: Department of Endocrinology, The Second Hospital of Lanzhou University, Lanzhou 730030, PR China. 13909313366@163.com
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Li
authors.forename: Ruihong
authors.initials: R
authors.lastname: Yue
authors.forename: Xuan
authors.initials: X
authors.lastname: Ren
authors.forename: Xiude
authors.initials: X
authors.lastname: Zhang
authors.forename: Anming
authors.initials: A
authors.lastname: Ni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000502:physiology; D002118:Calcium / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000652:urine; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D010710:Phosphates / Q000097:blood / Q000652:urine
chemical_list: D010710:Phosphates; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D002118:Calcium