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Mi Y, Wen O, Lei Z, Ge L, Xing L, Xi H. Insulin resistance and osteocalcin associate with the incidence and severity of postoperative delirium in elderly patients undergoing joint replacement. Geriatr Gerontol Int 2024; 24:421-429. [PMID: 38438300 DOI: 10.1111/ggi.14848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/30/2024] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
AIM While insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin. METHODS A total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non-delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose. Insulin resistance was assessed through the homeostatic model assessment of insulin resistance (HOMA-IR). MAIN RESULTS Out of the total, 28 patients (23.3%) experienced POD within 5 days after surgery. Patients with delirium exhibited higher levels of preoperative HOMA-IR and ucOC in CSF and plasma, and of tOC in CSF (P = 0.028, P < 0.001, P = 0.005, P = 0.019). After adjusting for variables, including age, Mini-Mental State Examination score, surgical site and preoperative fracture, only preoperative ucOC in CSF and HOMA-IR were significantly linked to the incidence of delirium (OR = 5.940, P = 0.008; OR = 1.208, P = 0.046, respectively), both of which also correlated with the severity of delirium (P = 0.007, P < 0.001). Receiver operating curve analysis indicated that preoperative HOMA-IR and ucOC in CSF might partly predict POD (area under the curve [AUC] = 0.697, 95% confidence interval [CI] = 0.501-0.775, AUC = 0.745, 95% CI = 0.659-0.860). CONCLUSIONS We observed that preoperative elevated HOMA-IR and ucOC in CSF were associated with the incidence and severity of POD. While these preliminary results need confirmation, they suggest a potential involvement of insulin resistance and osteocalcin in the pathological mechanism of POD. Geriatr Gerontol Int 2024; 24: 421-429.
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Affiliation(s)
- Yang Mi
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ouyang Wen
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhou Lei
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Long Ge
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Liu Xing
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - He Xi
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
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Kumar V, Bolanthakodi N, Vidyasagar S, Holla A, Sheik SM, Abhishek S. Association of serum osteocalcin with beta cell function, insulin resistance, and glycemic parameters in south Indian type 2 diabetic subjects. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance. Nutrients 2021; 13:nu13124358. [PMID: 34959910 PMCID: PMC8705502 DOI: 10.3390/nu13124358] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.
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Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients 2021; 13:nu13124349. [PMID: 34959901 PMCID: PMC8707041 DOI: 10.3390/nu13124349] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 01/11/2023] Open
Abstract
Patients with chronic kidney disease (CKD) and dialysis have higher mortality than those without, and cardiovascular disease (CVD) is the main cause of death. As CVD is caused by several mechanisms, insulin resistance plays an important role in CVD. This review summarizes the importance and mechanism of insulin resistance in CKD and discusses the current evidence regarding insulin resistance in patients with CKD and dialysis. Insulin resistance has been reported to influence endothelial dysfunction, plaque formation, hypertension, and dyslipidemia. A recent study also reported an association between insulin resistance and cognitive dysfunction, non-alcoholic fatty liver disease, polycystic ovary syndrome, and malignancy. Insulin resistance increases as renal function decrease in patients with CKD and dialysis. Several mechanisms increase insulin resistance in patients with CKD, such as chronic inflammation, oxidative stress, obesity, and mineral bone disorder. There is the possibility that insulin resistance is the potential future target of treatment in patients with CKD.
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Alharazy S, Alissa E, Lanham-New S, Naseer MI, Chaudhary AG, Robertson MD. Association between vitamin D and glycaemic parameters in a multi-ethnic cohort of postmenopausal women with type 2 diabetes in Saudi Arabia. BMC Endocr Disord 2021; 21:162. [PMID: 34380489 PMCID: PMC8359582 DOI: 10.1186/s12902-021-00825-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/18/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The relationship between vitamin D (VitD) and insulin sensitivity and secretion in type 2 diabetes mellitus (T2D) has been shown to be different amongst different ethnic populations. In Saudi Arabia, where both T2D and VitD deficiency are highly prevalent health concerns, little is known about the relationship between VitD, insulin sensitivity, resistance and the relative importance of ethnicity. Our primary aim in this study was to investigate influence of ethnicity on VitD association with glycaemic profile and to measures of obesity as a secondary outcome, among multiethnic postmenopausal women with T2D in Saudi Arabia. METHODS A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. Postmenopausal females (n = 173, age ≥ 50 years) with T2D were randomly selected in this study. Anthropometric measures and fasting blood samples were obtained for all study participants. Several biochemical parameters were measured including 25-hydroxyvitamin D (25(OH)D), glycosylated hemoglobin (HbA1c), insulin, glucose and c-peptide. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment 2 for insulin resistance and beta cell activity (HOMA2-IR, HOMA2-β). RESULTS Overall, 25(OH)D was inversely associated with fasting glucose (r=-0.165, P = 0.037), insulin (r=-0.184, P = 0.02), C-peptide (r=-0.19, P = 0.015) and HOMA2- IR C-peptide (r=-0.23, P = 0.004). Additionally, serum 25 (OH)D showed a negative correlation with body weight (r=-0.173 P = 0.028), waist and hip circumferences (r=-0.167, P = 0.033; r=-0.22, P = 0.004 respectively) but not with body mass index (BMI) or waist hip ratio (WHR). In the white ethnic group but not in black or Asian population groups, 25(OH)D level was also associated with only serum fasting C-peptide and HOMA2-IR C-peptide and BMI (P < 0.05). CONCLUSIONS Insulin resistance and obesity were associated with VitD status in T2D in this cohort. Our findings also suggest that these VitD associations in women from white ethnic background are different than in those from black/Asian ethnic backgrounds. Whether VitD supplements are able to improve either obesity and/or insulin sensitivity should be further investigated in different ethnic population groups.
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Affiliation(s)
- Shatha Alharazy
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eman Alissa
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Susan Lanham-New
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Muhammad Imran Naseer
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
| | - Adeel G. Chaudhary
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
- Centre for Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Denise Robertson
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Rafiq S, Jeppesen PB. Insulin Resistance Is Inversely Associated with the Status of Vitamin D in Both Diabetic and Non-Diabetic Populations. Nutrients 2021; 13:1742. [PMID: 34063822 PMCID: PMC8224049 DOI: 10.3390/nu13061742] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D has been implicated in the regulation of glucose metabolism and insulin resistance. We designed this study to provide evidence that insulin resistance is dependent on the concentration of vitamin D in the body. Forty observational studies of both type 2 diabetes mellitus patients and healthy subjects were included in this meta-analysis. Related articles were searched from Embase, PubMed, and Medline through January 2021. Filters for search were used to obtain more focused results. We used Comprehensive Meta-Analysis Version 3 for the construction of forest plots. RevMan software version 5.3 was used to build the risk of bias tables and summary plots. The observational studies included in this systematic review and meta-analysis showed an inverse relationship of insulin resistance with the status of vitamin D both in non-diabetic (r = -0.188; 95% CI = -0.141 to -0.234; p = 0.000) and diabetic (r = -0.255; 95% CI = -0.392 to -0.107, p = 0.001) populations. From the meta-analysis we concluded that hypovitaminosis D is related to increased levels of insulin resistance in both type 2 diabetes patients and the healthy population all over the world.
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Affiliation(s)
- Shamaila Rafiq
- Department of Clinical Medicine, Aarhus University, Aarhus N, 8200 Aarhus, Denmark;
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Kord-Varkaneh H, Tangestani H, Mansouri S, Rahimi-Foroushani A, Shab-Bidar S. Association of body mass index and waist circumference with osteocalcin and C-terminal telopeptide in Iranian elderly: results from a cross-sectional study. J Bone Miner Metab 2019; 37:179-184. [PMID: 29476244 DOI: 10.1007/s00774-018-0912-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/28/2018] [Indexed: 10/18/2022]
Abstract
There is no agreement on the role of obesity as a protection or unfavorable factor on bone. In the present study, the association of body mass index (BMI) and waist circumference (WC) with osteocalcin, C-terminal telopeptide of type 1 collagen (CTX-I), highly sensitive C-reactive protein (hs-CRP), parathormon (PTH) and 25-hydroxyvitamin D (25(OH)D) in elderly people was investigated. This cross-sectional study was conducted on 178 elderly residents in Tehran, with a mean age of 67.04 (60-83). Serum osteocalcin, hs-CRP, 25(OH) D, PTH and urine CTX-I were measured for all participants. Waist circumference, weight and height were measured and BMI was calculated. Linear regression and Pearson correlation were performed to evaluate the relation of BMI and waist circumference with other variables. A significant inverse association was found between BMI with osteocalcin (β = - 0.171, p = 0.027) after control for covariates. In addition, there were a significant relation of BMI and WC with hs-CRP (β = 0.246, p = 0.002 and β = 0.219, p = 0.006, respectively) and PTH (β = 0.1169, p = 0.040 and β = 0.200, p = 0.018), respectively. The present study did not show a significant relation of BMI and WC with urine CTX-I even after adjustment for potential confounders (β = - 0.143, p = 0.065 and β = - 0.104, p = 0.183, respectively). The present study has concluded that obesity is an undesirable factor for bone metabolism by reducing serum osteocalcin and by increasing hs-CRP and PTH which contribute to bone resorption.
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Affiliation(s)
- Hamed Kord-Varkaneh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44 Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Hadith Tangestani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44 Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Sara Mansouri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44 Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Abbas Rahimi-Foroushani
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44 Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran.
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Abstract
The skeleton shows an unconventional role in the physiology and pathophysiology of the human organism, not only as the target tissue for a number of systemic hormones, but also as endocrine tissue modulating some skeletal and extraskeletal systems. From this point of view, the principal cells in the skeleton are osteocytes. These cells primarily work as mechano-sensors and modulate bone remodeling. Mechanically unloaded osteocytes synthetize sclerostin, the strong inhibitor of bone formation and RANKL, the strong activator of bone resorption. Osteocytes also express hormonally active vitamin D (1,25(OH)2D) and phosphatonins, such as FGF23. Both 1,25(OH)2D and FGF23 have been identified as powerful regulators of the phosphate metabolism, including in chronic kidney disease. Further endocrine cells of the skeleton involved in bone remodeling are osteoblasts. While FGF23 targets the kidney and parathyroid glands to control metabolism of vitamin D and phosphates, osteoblasts express osteocalcin, which through GPRC6A receptors modulates beta cells of the pancreatic islets, muscle, adipose tissue, brain and testes. This article reviews some knowledge concerning the interaction between the bone hormonal network and phosphate or energy homeostasis and/or male reproduction.
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Affiliation(s)
- I. ZOFKOVA
- Institute of Endocrinology, Prague, Czech Republic
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Kord-Varkaneh H, Djafarian K, Khorshidi M, Shab-Bidar S. Association between serum osteocalcin and body mass index: a systematic review and meta-analysis. Endocrine 2017; 58:24-32. [PMID: 28822067 DOI: 10.1007/s12020-017-1384-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 07/24/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Osteocalcin is considered as a bone-derived hormone affecting on the body fat distribution and body mass index. Several cross-sectional studies have investigated the association between serum osteocalcin and body mass index. The aim of this study was to summarize the evidence on the relationship between serum osteocalcin and body mass index. METHODS We conducted a complete search up to November 2016 in PubMed and SCOPUS and reviewed reference list of all relevant articles and reviews. The DerSimonian-Laird method were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the standard χ 2 test.To find possible the sources of between-study heterogeneity, we carried out subgroup analyses based on sex, and type of study population. RESULTS There was a significant inverse association in the overall result of this study between serum osteocalcin levels and BMI(r = -0.161; 95% CI: -0.197, -0.124, p < 0.000). In the subgroup analysis to find the sources of significant heterogeneity between-study, we observed that the type of the study population may be the source of between-study heterogeneity and the most correlation was seen in metabolic syndrome studies (r = -0.265; p = 0.000). CONCLUSION Findings from the available data indicated an overall significant inverse association between serum osteocalcin and body mass index. Further studies based on the type of study population are needed to better clarify these associations.
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Affiliation(s)
- Hamed Kord-Varkaneh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Amir Abad, Keshavarz Boulevard, P. O. Box 14155/6117, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khorshidi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Amir Abad, Keshavarz Boulevard, P. O. Box 14155/6117, Tehran, Iran.
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El Hayek Fares J, Weiler HA. Implications of the nutrition transition for vitamin D intake and status in Aboriginal groups in the Canadian Arctic. Nutr Rev 2017; 74:571-83. [PMID: 27534942 DOI: 10.1093/nutrit/nuw020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aboriginal Canadians have low intakes of vitamin D and are shifting away from consumption of traditional foods. Higher body mass index, skin pigmentation, and geographic latitude of residence further predispose Canadian Aboriginal populations to low vitamin D status. Low vitamin D status could compromise bone health and other health outcomes. Studies assessing vitamin D status of different Aboriginal groups are limited. The aim of this review is to examine the literature on vitamin D status and intakes of Canadian Aboriginal populations living in the Arctic. PubMed was searched for relevant articles published from 1983 to 2013. The prevalence of 25-hydroxy vitamin D deficiency ranged from 13.9% to 76.0% among children and adults in the summer. Furthermore, mean vitamin D intakes among all age groups were below the estimated average requirement. As vitamin D deficiency has been recently associated with chronic diseases, and Aboriginal populations living in the Arctic are at high risk for low vitamin D status, their vitamin D status should be assessed regularly across seasons.
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Affiliation(s)
- Jessy El Hayek Fares
- J.E.H. Fares and H.A. Weiler are with the School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada, and the Centre for Indigenous Peoples' Nutrition and Environment, Sainte-Anne-de-Bellevue, Quebec, Canada. J.E.H. Fares is with the Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mikael, Lebanon
| | - Hope A Weiler
- J.E.H. Fares and H.A. Weiler are with the School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada, and the Centre for Indigenous Peoples' Nutrition and Environment, Sainte-Anne-de-Bellevue, Quebec, Canada. J.E.H. Fares is with the Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mikael, Lebanon.
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Shu H, Pei Y, Chen K, Lu J. Significant inverse association between serum osteocalcin and incident type 2 diabetes in a middle-aged cohort. Diabetes Metab Res Rev 2016; 32:867-874. [PMID: 27061949 DOI: 10.1002/dmrr.2808] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/07/2016] [Accepted: 04/05/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Accumulating evidence indicates that osteocalcin links bone formation to glucose homeostasis. However, the correlation between osteocalcin and incident type 2 diabetes has been controversial based on the limited results of cohort studies. We examined the link between serum osteocalcin and glucose homeostasis including incident type 2 diabetes in a 3-year follow-up study. METHODS This retrospective study enrolled 1870 middle-aged subjects (1279 men, 591 women) at Chinese PLA General Hospital who were followed-up for 3 years. Cox proportional hazards regression was used to determine whether incident type 2 diabetes was influenced by the osteocalcin concentrations measured with an electrochemiluminescence immunoassay. RESULTS At baseline, the blood glucose levels and prevalence of metabolic syndrome varied inversely with the osteocalcin quartiles. During follow-up, type 2 diabetes developed in 80 of the 1870 subjects. The prevalence decreased with osteocalcin quartiles (P = 0.016). In models adjusted for metabolism-related parameters, osteocalcin was inversely associated with fasting plasma glucose {β = -0.017 [95% confidence interval (CI), -0.034-0.00], P = 0.040}. Osteocalcin was inversely related to the risk of incident type 2 diabetes assessed using a model adjusted for glucose metabolic parameters, 25-hydroxy vitamin D3 and parathyroid hormone (hazard ratio [HR] = 0.09 [95% CI, 0.01-0.96], P = 0.046). The onset risk of diabetes in the first osteocalcin quartile was higher than in the fourth quartile (HR = 1.67 [95% CI, 0.96-3.48], P = 0.035). The correlation was strongly significant after fully adjusting for glucose related parameters and bone turnover (HR = 3.02 [95% CI, 1.25-7.32], P = 0.014). CONCLUSIONS Low serum osteocalcin concentrations at baseline were independently related to an increased risk of incident type 2 diabetes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hua Shu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Yu Pei
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Kang Chen
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Juming Lu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
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Reeds J, Mansuri S, Mamakeesick M, Harris SB, Zinman B, Gittelsohn J, Wolever TMS, Connelly PW, Hanley A. Dietary Patterns and Type 2 Diabetes Mellitus in a First Nations Community. Can J Diabetes 2016; 40:304-10. [PMID: 27374251 DOI: 10.1016/j.jcjd.2016.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus is a growing concern worldwide, particularly in Indigenous communities, which have undergone a marked nutrition transition characterized by reduced intakes of traditional foods and increased intakes of market foods. Few studies have assessed the relationships between differing dietary patterns and risk for type 2 diabetes in Indigenous communities in Canada. The objective of the study was to characterize dietary patterns using factor analysis (FA) and to relate these patterns to the incidence of type 2 diabetes after 10 years of follow up in a First Nations community in Ontario, Canada. METHODS We conducted a prospective analysis of 492 participants in the SLHDP who did not have diabetes at baseline (1993 to 1995) and were followed for 10 years. A food-frequency questionnaire was administered, and FA was used to identify patterns of food consumption. Multivariate logistic regression analyses determined associations of food patterns with incident type 2 diabetes, adjusting for sociodemographic and lifestyle confounders. RESULTS At follow up, 86 participants had developed incident type 2 diabetes. FA revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes. CONCLUSIONS Dietary interventions should encourage reduced consumption of unhealthful market foods, in combination with improvements in local food environments so as to increase access to healthful foods and reduce food insecurity in Indigenous communities.
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Affiliation(s)
- Jacqueline Reeds
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Sudaba Mansuri
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Mary Mamakeesick
- Sandy Lake Health and Diabetes Project, Sandy Lake, Ontario, Canada
| | - Stewart B Harris
- Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Bernard Zinman
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Joel Gittelsohn
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas M S Wolever
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Phillip W Connelly
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Anthony Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Sandy Lake Health and Diabetes Project, Sandy Lake, Ontario, Canada.
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Liu DM, Guo XZ, Tong HJ, Tao B, Sun LH, Zhao HY, Ning G, Liu JM. Association between osteocalcin and glucose metabolism: a meta-analysis. Osteoporos Int 2015; 26:2823-33. [PMID: 26089135 DOI: 10.1007/s00198-015-3197-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/01/2015] [Indexed: 01/15/2023]
Abstract
UNLABELLED This meta-analysis aimed to investigate the associations between osteocalcin (Ocn) and fasting plasma glucose (FPG) and glycated hemoglobin A1c (HbA1c). It was revealed that both total Ocn and undercarboxylated Ocn (unOcn) were negatively related with FPG and HbA1c, and the association of unOcn with FPG was more pronounced in men. INTRODUCTION The aim of this study was to investigate the strength of associations between Ocn and FPG and HbA1c using a meta-analysis approach. METHODS A search was carried out using the databases of PubMed, ISI Web of Science, and the Cochrane library from 2007 to 2014 to identify related studies. A pooled effect size with 95 % confidence intervals (CI) was derived. RESULTS The meta-analysis included 39 studies involving 23,381 participants. The overall correlation was -0.16 (95 % CI, -0.19 to -0.14) between total Ocn (tOcn) and FPG and -0.15 (95 % CI, -0.20 to -0.11) between undercarboxylated Ocn (unOcn) and FPG. In the analysis of the association between Ocn and HbA1c, the pooled correlation was -0.16 (95 % CI, -0.18 to -0.14) for tOcn and -0.16 (95 % CI, -0.23 to -0.08) for unOcn. The magnitude of the correlation between unOcn and FPG is significantly higher in men than in women (r = -0.18, 95 % CI, -0.21 to -0.14; r = -0.09, 95 % CI, -0. 13 to -0.05, respectively; P for interaction < 0.05). Similar trend was also found between unOcn and HbA1c but without significance (for men, r = -0.19, 95 % CI, -0.24 to -0.14; for women, r = -0.09, 95 % CI, -0.22 to 0.04, respectively; P for interaction > 0.05). No indication of significant publication bias was found in any method. CONCLUSIONS This meta-analysis demonstrated that both unOcn and tOcn were similarly and negatively correlated with FPG and HbA1c in humans. The negative correlations between unOcn and glucose metabolism appear to be more pronounced in men than in women.
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Affiliation(s)
- D-M Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - X-Z Guo
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - H-J Tong
- Institut de Recherches Cliniques de Montréal (IRCM) Department of Microbiology and Immunology, University of Montreal and Division of Experimental Medicine, McGill University, Montreal, QC, H2W 1R7, Canada
| | - B Tao
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - L-H Sun
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - H-Y Zhao
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - G Ning
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China.
| | - J-M Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China.
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14
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Mansuri S, Badawi A, Kayaniyil S, Cole DE, Harris SB, Mamakeesick M, Maguire J, Zinman B, Connelly PW, Hanley AJ. Associations of circulating 25(OH)D with cardiometabolic disorders underlying type 2 diabetes mellitus in an Aboriginal Canadian community. Diabetes Res Clin Pract 2015; 109:440-9. [PMID: 25944538 DOI: 10.1016/j.diabres.2015.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/23/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
Abstract
AIMS To investigate the associations of 25-hydroxyvitamin D (25(OH)D) with insulin resistance (IR), beta-cell function and metabolic syndrome (MetS) in a First Nations population. METHODS We conducted a cross-sectional analysis using data from the Sandy Lake Health and Diabetes Project (2003-2005). A total of 390 participants (>12 y) were assessed for 25(OH)D, fasting glucose, insulin, lipids, blood pressure, inflammatory markers, anthropometric and lifestyle variables and a 75-g oral glucose tolerance test was administered. IR was calculated using the Matsuda insulin sensitivity index (ISOGTT) and the computational homeostasis model assessment of IR (HOMA2-IR). Beta-cell function was calculated using the insulinogenic index (IGI) divided by HOMA-IR (IGI/IR) and the insulin secretion sensitivity index-2 (ISSI-2). The 2009 harmonized criteria were used to define MetS. RESULTS Higher 25(OH)D was associated with a decreased prevalence of dysglycemia (OR = 0.71 95% CI, 0.51-0.97 per SD increase). In addition, there were significant associations of 25(OH)D with measures of insulin action (ISOGTT; beta=0.31; 95% CI, 0.12, 0.49; HOMA2-IR; beta = -29; 95% CI -0.46, -0.11 and beta-cell function (ISSI-2; beta = 0.15; 95% CI, 0.02, 0.28). The prevalence of MetS was 41%. There was a decreased risk (OR=0.73, 95% CI 0.56, 0.94) of MetS per SD increase in baseline 25(OH)D. Finally, there was a significant positive association of 25(OH)D with adiponectin (beta = 0.16; 95% CI = 0.01, 0.31). CONCLUSIONS These results support a potential role for vitamin D metabolism in the natural history of T2DM among Aboriginal Canadians, although carefully designed randomized trials will be required to establish causality.
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Affiliation(s)
- Sudaba Mansuri
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Alaa Badawi
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
| | - Sheena Kayaniyil
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - David E Cole
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Stewart B Harris
- Center for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Jonathon Maguire
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Bernard Zinman
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Philip W Connelly
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.
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15
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Derakhshanian H, Shab-Bidar S, Speakman JR, Nadimi H, Djafarian K. Vitamin D and diabetic nephropathy: A systematic review and meta-analysis. Nutrition 2015; 31:1189-94. [PMID: 26238534 DOI: 10.1016/j.nut.2015.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/11/2015] [Accepted: 04/13/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE There has been a long history documenting the use of different vitamin D derivatives as therapy for renal diseases. However, to our knowledge, there is no comprehensive assessment of the relation between vitamin D deficiency and risk for diabetic nephropathy (DN). Additionally, the effect of vitamin D supplementation on DN is still unclear. The aim of this meta-analysis was to assess these issues by pooling together the results from cross-sectional studies and clinical trials. METHODS A systematic literature search of PubMed, Scopus, and Google Scholar was conducted, ending in September 2014. For cross-sectional studies, odds ratio was used as a measure of the association between vitamin D status and risk for DN; for clinical trials, mean and SD of the main outcome (urine albumin-to-creatinine ratio [UACR]) in intervention and placebo groups were considered for analysis. RESULTS The final selected articles were published between 2009 and 2014. In all, 3700 and 219 patients were enrolled in observational and interventional studies, respectively. The pooled odds ratio from six cross-sectional studies was 1.80 (95% confidence interval [CI], 1.25-2.59; P = 0.002), indicating a significant inverse association between serum vitamin D status and risk for nephropathy in patients with diabetes. However, the pooled data of UACR levels in clinical trials suggested no significant change following vitamin D supplementation (17.98; 95% CI, -35.35 to 71.32; P = 0.51). CONCLUSION This meta-analysis showed the higher risk for nephropathy in vitamin D-deficient patients with diabetes. Pooling the results of available clinical trials after vitamin D supplementation did not support causality in this association.
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Affiliation(s)
- Hoda Derakhshanian
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - John R Speakman
- Division of Energy Balance and Obesity, Aberdeen Centre for Energy Regulation and Obesity, Rowett Research Institute, Bucksburn, Aberdeen, Scotland, United Kingdom
| | - Hoda Nadimi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
Bone is a target tissue for hormones, such as the sex steroids, parathormon, vitamin D, calcitonin, glucocorticoids, and thyroid hormones. In the last decade, other "non-classic" hormones that modulate the bone tissue have been identified. While incretins (GIP and GLP-1) inhibit bone remodeling, angiotensin acts to promote remodeling. Bone morphogenetic protein (BMP) has also been found to have anabolic effects on the skeleton by activating bone formation during embryonic development, as well as in the postnatal period of life. Bone has also been identified as an endocrine tissue that produces a number of hormones, that bind to and modulate extra-skeletal receptors. Osteocalcin occupies a central position in this context. It can increase insulin secretion, insulin sensitivity and regulate metabolism of fatty acids. Moreover, osteocalcin also influences phosphate metabolism via osteocyte-derived FGF23 (which targets the kidneys and parathyroid glands to control phosphate reabsorption and metabolism of vitamin D). Finally, osteocalcin stimulates testosterone synthesis in Leydig cells and thus may play some role in male fertility. Further studies are necessary to confirm clinically important roles for skeletal tissue in systemic regulations.
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Affiliation(s)
- I Zofkova
- Institute of Endocrinology, Prague, Czech Republic.
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17
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Ferron M, Lacombe J. Regulation of energy metabolism by the skeleton: Osteocalcin and beyond. Arch Biochem Biophys 2014; 561:137-46. [DOI: 10.1016/j.abb.2014.05.022] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 12/30/2022]
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18
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Mager DR, Jackson ST, Hoffmann MR, Jindal K, Senior PA. "Vitamin D supplementation and bone health in adults with diabetic nephropathy: the protocol for a randomized controlled trial". BMC Endocr Disord 2014; 14:66. [PMID: 25115438 PMCID: PMC4146441 DOI: 10.1186/1472-6823-14-66] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/06/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Suboptimal vitamin D status is highly prevalent in Northern communities, particularly in those patients with chronic diseases such as diabetes and chronic renal disease. Emerging literature suggests that adherence to daily vitamin D supplementation may be an important factor influencing vitamin D status and overall bone health, but compliance with therapies for bone health is a major challenge. It is unknown what level of vitamin D supplementation will ameliorate or improve suboptimal vitamin D status in patients with diabetic nephropathy or contribute to improved bone health, particularly for those living in northern climates. METHODS/DESIGN The study purpose was to examine two different strategies of vitamin D3 supplementation; daily dosing of 2000 IU per day verses monthly dosing of 40,000 IU per month on markers of vitamin D status, bone health and to examine whether adherence, quality of life and patient satisfaction with the supplementation strategy differs between the two vitamin D strategies in adults diagnosed with diabetic nephropathy. DISCUSSION The need for RCTs assessing higher doses of vitamin D3 supplementation at varying frequencies of administration and its impact on bone health in adults with diabetes and chronic kidney disease are needed. TRIAL REGISTRATION ClinicalTrials.gov NCT01476501.
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Affiliation(s)
- Diana R Mager
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Stephanie T Jackson
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Michelle R Hoffmann
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Kailash Jindal
- Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, AB, Canada
- Northern Alberta Renal Program, Edmonton, AB, Canada
- Department of Nephrology, University of Alberta, Edmonton, AB, Canada
| | - Peter A Senior
- Diabetic Nephropathy Prevention Clinic, Alberta Health Services, Edmonton, AB, Canada
- Department of Endocrinology, University of Alberta, Edmonton, AB, Canada
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19
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Poomthavorn P, Nantarakchaikul P, Mahachoklertwattana P, Chailurkit LO, Khlairit P. Effects of correction of vitamin D insufficiency on serum osteocalcin and glucose metabolism in obese children. Clin Endocrinol (Oxf) 2014; 80:516-23. [PMID: 24107003 DOI: 10.1111/cen.12337] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/20/2013] [Accepted: 09/17/2013] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Osteocalcin (OCN) and vitamin D insufficiency (VDI) have been shown to be associated with abnormal glucose metabolism (GluMet). Whether correction of VDI affects serum OCN is unknown. This study evaluated the effects of correction of VDI on OCN and GluMet, and determined the associations of OCN with 25-hydroxyvitamin D (25-OHD) and GluMet. DESIGN, PATIENTS AND MEASUREMENTS This study involved 230 obese children in a cross-sectional part and 72 participants in a prospective part in which children with VDI were treated with vitamin D2 at a dose of 20 000 IU daily for 28 days. All 230 children underwent an oral glucose tolerance test and had their serum total and undercarboxylated OCNs and 25-OHD measured. Forty of 72 children were reassessed for the GluMet and serum total and undercarboxylated OCNs and 25-OHD after the vitamin D2 treatment. RESULTS In the prospective part, correction of VDI by raising mean (SD) 25-OHD of 51·5 (12·3) to 141·8 (40·8) nmol/l resulted in an improvement of their GluMet and increase in their whole-body insulin sensitivity index with no changes in their OCN measures. In the cross-sectional part, after adjustments for age, sex and puberty, the total (β = 0·322) and undercarboxylated OCNs (β = 0·315) were positively associated with insulinogenic index, which is an index of insulin secretion (P = 0·034 and 0·037, respectively) in the group of prediabetic and diabetic children. CONCLUSIONS Correction of VDI increased insulin sensitivity and improved GluMet, but had no effect on serum OCN measures. OCN was associated with increased insulin secretion in children with abnormal GluMet.
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Affiliation(s)
- Preamrudee Poomthavorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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20
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Srikanthan P, Crandall CJ, Miller-Martinez D, Seeman TE, Greendale GA, Binkley N, Karlamangla AS. Insulin resistance and bone strength: findings from the study of midlife in the United States. J Bone Miner Res 2014; 29:796-803. [PMID: 23983216 PMCID: PMC3935990 DOI: 10.1002/jbmr.2083] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 07/30/2013] [Accepted: 08/13/2013] [Indexed: 12/11/2022]
Abstract
Although several studies have noted increased fracture risk in individuals with type 2 diabetes mellitus (T2DM), the pathophysiologic mechanisms underlying this association are not known. We hypothesize that insulin resistance (the key pathology in T2DM) negatively influences bone remodeling and leads to reduced bone strength. Data for this study came from 717 participants in the Biomarker Project of the Midlife in the United States Study (MIDUS II). The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting morning blood glucose and insulin levels. Projected 2D (areal) bone mineral density (BMD) was measured in the lumbar spine and left hip using dual-energy X-ray absorptiometry (DXA). Femoral neck axis length and width were measured from the hip DXA scans, and combined with BMD and body weight and height to create composite indices of femoral neck strength relative to load in three different failure modes: compression, bending, and impact. We used multiple linear regressions to examine the relationship between HOMA-IR and bone strength, adjusted for age, gender, race/ethnicity, menopausal transition stage (in women), and study site. Greater HOMA-IR was associated with lower values of all three composite indices of femoral neck strength relative to load, but was not associated with BMD in the femoral neck. Every doubling of HOMA-IR was associated with a 0.34 to 0.40 SD decrement in the strength indices (p<0.001). On their own, higher levels of fasting insulin (but not of glucose) were independently associated with lower bone strength. Our study confirms that greater insulin resistance is related to lower femoral neck strength relative to load. Further, we note that hyperinsulinemia, rather than hyperglycemia, underlies this relationship. Although cross-sectional associations do not prove causality, our findings do suggest that insulin resistance and in particular, hyperinsulinemia, may negatively affect bone strength relative to load.
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Affiliation(s)
- Preethi Srikanthan
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
| | - Carolyn J. Crandall
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
| | - Dana Miller-Martinez
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
| | - Teresa E. Seeman
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
| | - Gail A. Greendale
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
| | - Neil Binkley
- Osteoporosis Clinical Center Univ of Wisconsin-Madison, Madison, WI
| | - Arun S. Karlamangla
- Department of Medicine David Geffen School of Medicine at UCLA Los Angeles, California, USA
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Vitamin D and cardiovascular disease: is there evidence to support the bandwagon? Curr Atheroscler Rep 2013; 14:525-34. [PMID: 22961073 DOI: 10.1007/s11883-012-0281-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In the last 3 years, more evidence accumulated that vitamin D (vitD)deficiency associates with cardiovascular disease (CVD) and risk factors. The association with higher cardiovascular (CV) mortality was stronger than with nonfatal CVD events. A higher incidence of type 2 diabetes was also shown. Many factors related to lifestyle (physical activity in particular) influence both vitD levels and CVD, and may contribute to explain these observational data. Whether the association between vitD and CVD is causal can only be established through randomized controlled trials (RCTs), and to date the results of the randomized trials, which were not designed for investigating CV outcomes, do not support the association data. Answers on the effects of vitD supplementation on primary and secondary prevention of CV may be found in the specifically designed ongoing RCTs. In the mean time, low vitamin D levels should be regarded as a marker of unhealthy lifestyle, requiring a more aggressive attempt at modifying individual lifestyle.
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22
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Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol 2013; 2013:846480. [PMID: 23737779 PMCID: PMC3657394 DOI: 10.1155/2013/846480] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 12/22/2022] Open
Abstract
Osteocalcin is the most abundant noncollagenous protein of bone matrix. Once transcribed, this protein undergoes posttranslational modifications within osteoblastic cells before its secretion, including the carboxylation of three glutamic residues in glutamic acid, which is essential for hydroxyapatite binding and deposition in the extracellular matrix of bone. Recent provocative data from experimental observations in mice showed that the circulating undercarboxylated fraction of osteocalcin increases insulin secretion and sensitivity, lowers blood glucose, and decreases visceral fat in both genders, while it enhances testosterone production by the testes in males. Moreover, both total and undercarboxylated osteocalcins increase following physical activity with potential positive effects on glucose tolerance. Despite that these evidences have been only in part confirmed in humans, further prospective investigations are needed to definitively establish the endocrine role of osteocalcin both in the general population and cohorts of patients with diabetes or other metabolic disorders.
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Affiliation(s)
- Aurora Patti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
- *Aurora Patti:
| | - Luigi Gennari
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Daniela Merlotti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Francesco Dotta
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Ranuccio Nuti
- Department of Clinical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
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