title: Bone remodelling markers in hypertensive patients with and without diabetes mellitus: link between bone and glucose metabolism.
abstract: OBJECTIVE
  Growing evidence suggests the presence of a complex interplay between hypertension as well as type 2 diabetes mellitus (DM) and osteoporosis. The present study was designed to investigate a possible effect of type 2 DM on bone remodelling markers such as osteoprotegerin and N-terminal propeptide of type 1 collagen (P1NP) in hypertensive patients.
  
  
  METHODS
  The 100 study participants were divided into three groups according to the presence of DM and hypertension: group one included diabetic hypertensive subjects, group 2 included hypertensive subjects without diabetes and group 3 included subjects without hypertension and without DM (controls). Blood sampling for metabolic parameters, including osteoprotegerin, P1NP, adiponectin, fasting glucose, HbA1c , CRP, homeostasis model assessment-insulin resistance, homeostasis model assessment-beta function was performed.
  
  
  RESULTS
  Circulating P1NP increased from group 1 to group 3 in a continuous fashion. P1NP was significantly lower in hypertensive subjects with DM (group 1), than in groups 2 and 3 (p < 0.0001). P1NP, was marginally lower in diabetic hypertensive subjects as compared with nondiabetic subjects with hypertension (p = 0.079). Circulating osteoprotegerin did not differ significantly between groups (p = 0.593).
  
  
  CONCLUSIONS
  In the present study, bone formation marker, P1NP, was significantly lower in diabetic hypertensive subjects as compared with nondiabetic subjects with and without hypertension. P1NP was inversely associated with parameters of glucose homeostasis such as fasting glucose, HbA1c and positively with homeostasis model assessment-beta cell function. Type 2 DM was associated with an adverse effect on bone formation independently of age, sex and exposure to anti-diabetic drugs.
authors.affiliation: Department of Diabetic Foot, Wolfson Medical Center, Holon, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Feldbrin
authors.affiliation: Department of Endocrinology, Wolfson Medical Center, Holon, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Shargorodsky
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000368:Aged; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism*; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000378:metabolism*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000378:metabolism; D053244:Osteoprotegerin / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011347:Procollagen / Q000378:metabolism*
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D053244:Osteoprotegerin; D010446:Peptide Fragments; D011347:Procollagen; C499918:ADIPOQ protein, human; C506030:TNFRSF11B protein, human; C517652:hemoglobin A1c protein, human; C047202:procollagen Type I N-terminal peptide
keywords: bone remodelling; hypertension; osteoporosis; type 2 diabetes mellitus