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He X, Liu M, Ding X, Bian N, Wang J, Wang G, Liu J. Parathyroid Hormone is Negatively Correlated with Glycated Hemoglobin in Newly Diagnosed Type 2 Diabetic Patients. Int J Endocrinol 2024; 2024:8414689. [PMID: 38590929 PMCID: PMC11001476 DOI: 10.1155/2024/8414689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/16/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
Objective The growing evidence shows that parathyroid hormone (PTH) may affect glucose metabolism. However, the relationship between them is still controversial among diabetic patients. The current study aimed to investigate the relationship between PTH and glucose metabolism in the patients with newly diagnosed type 2 diabetes (T2D). Methods A total of 532 participants, including 387 patients with newly diagnosed T2D and 145 healthy controls, were recruited in the present study. PTH and metabolic parameters were measured in all participants. Results The PTH levels were significantly lower in the newly diagnosed T2D patients compared with the control group (35.10 (25.90, 47.20) vs. 47.15 (35.83, 58.65) pg/ml, P < 0.001). The T2D patients with a higher glycated hemoglobin (HbA1c) tertile had lower PTH levels than the patients with a lower HbA1c tertile (32.90 (24.85, 41.40) vs. 37.50 (26.10, 54.55) pg/ml, P < 0.001). Spearman correlation analysis showed that PTH was positively correlated with the body mass index (BMI), fasting insulin (FINS), homeostasis model assessment of β-cell function (HOMA-β), and homeostasis model assessment of insulin resistance (HOMA-IR) and negatively correlated with HbA1c, blood calcium (Ca), blood phosphorus (P), and 25-hydroxyvitamin D3 (25-OH-D3). Multiple linear regression analysis demonstrated that PTH was significantly associated with HbA1c (β = -1.475, P=0.003) and HOMA-β (β = 0.090, P=0.001) after adjusting for age, sex, BMI, season, 25-OH-D3, Ca, and P. Conclusion PTH was negatively correlated with HbA1c in the newly diagnosed T2D patients. Our results suggested that the PTH level within the reference range is related to islet β-cell function and hyperglycemia.
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Affiliation(s)
- Xueqing He
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Man Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Xiaoyu Ding
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Nannan Bian
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiaxuan Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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Zhao H, Zhang M, Zhen Y, Tang Y. The Relationships Between Glycated Hemoglobin and Bone Turnover Markers in Patients with Type 2 Diabetes but No Diabetic Nephropathy. Int J Gen Med 2022; 15:5591-5598. [PMID: 35712058 PMCID: PMC9192782 DOI: 10.2147/ijgm.s366725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/26/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To investigate the relationships between glycated hemoglobin (HbA1c) level and bone turnover markers (BTMs) in patients with type 2 diabetes mellitus (T2DM) but no diabetic nephropathy. Patients and Methods Patients with T2DM were recruited at Hebei General Hospital in China. The participants were allocated to three groups: an HbA1c <7% group, an HbA1c 7%–9% group, and an HbA1c ≥9% group. Their general characteristics, biochemical indices, and BTM concentrations were recorded. Results The ages of the HbA1c <7% group and the HbA1c 7%–9% group were significantly higher than that of the HbA1c ≥9% group (P<0.05). The prevalence of a history of hypertension in the HbA1c 7%–9% group was significantly higher than that in the HbA1c ≥9% group. The circulating low-density lipoprotein-cholesterol concentration in the HbA1c ≥9% group and the apolipoprotein B concentration in the HbA1c 7%–9% group were significantly higher than those in the HbA1c <7% group (P<0.05). Compared with that in the HbA1c <7% group, the circulating 25-hydroxyvitamin D (25OHD) concentration was significantly lower in the HbA1c ≥9% group (P<0.05). Additionally, the circulating 25OHD and osteocalcin (OC) concentrations negatively correlated with HbA1c (P<0.05). Conclusion An increase in HbA1c is associated with gradual decreases in the circulating concentrations of 25OHD and OC.
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Affiliation(s)
- Hang Zhao
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Miaomiao Zhang
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, 050017, People's Republic of China
| | - Yunfeng Zhen
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yong Tang
- Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China
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Sun S, Wang Y, Ma W, Cheng B, Dong B, Zhao Y, Hu J, Zhou Y, Huang Y, Wei F, Wang Y. Normal parathyroid hormone and non-proliferative diabetic retinopathy in patients with type 2 diabetes. J Diabetes Investig 2021; 12:1220-1227. [PMID: 33135333 PMCID: PMC8264395 DOI: 10.1111/jdi.13456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/13/2020] [Accepted: 10/29/2020] [Indexed: 01/20/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the associations between parathyroid hormone (PTH) and non-proliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes mellitus. MATERIALS AND METHODS Data were collected from 2,322 patients with type 2 diabetes mellitus in hospital between 2017 and 2019. The odds ratio (OR) and the corresponding 95% confidence interval related to the quartiles of PTH were obtained by logistic regression analysis after adjusting the potential confounding variation. RESULTS The patients were stratified into quartiles (Q1-Q4) based on the PTH levels, with the cut-off limits of ≤23.74, 23.74-29.47, 29.47-37.30 and >37.30 pg/mL in men, and ≤24.47, 24.47-31.22, 31.22-39.49 and >39.49 pg/mL in women. The first quartile (Q1) represents the lowest quartile and the fourth quartile (Q4) is the highest. According to the quartiles (Q1-Q4), the prevalence rate of NPDR in patients showed a significantly decreasing trend (37.9%, 36.3%, 34.0% vs 24.0% in men; 43.2%, 40.5%, 31.1% vs 26.2% in women, both P < 0.05). Independent of age, diabetes duration and other metabolic factors, multivariate logistic regression showed that participants in Q4 had a lower OR of NPDR than those in Q1 (OR 0.443, 95% confidence interval 0.300-0.654, P < 0.001 for men; OR 0.428, 95% confidence interval 0.283-0.646, P < 0.001 for women). CONCLUSIONS Low serum PTH levels were significantly associated with complications of NPDR in inpatients. Its causality remains to be further studied.
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Affiliation(s)
- Shengnan Sun
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Yahao Wang
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Wenru Ma
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Bingfei Cheng
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Bingzi Dong
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Yuhang Zhao
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Jianxia Hu
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Yue Zhou
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Yajing Huang
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Fanxiang Wei
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
| | - Yangang Wang
- Department of EndocrinologyAffiliated Hospital of Medical College Qingdao UniversityQingdaoChina
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AlQuaiz AM, Alrasheed AA, Kazi A, Batais MA, Alhabeeb KM, Jamal A, Fouda MA. Is 25-Hydroxyvitamin D Associated with Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia? A Population Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062805. [PMID: 33801988 PMCID: PMC7999091 DOI: 10.3390/ijerph18062805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Saudi Arabia has a high burden of diabetes mellitus and vitamin D deficiency. The objective of this study was to explore the association between glycosylated hemoglobin and 25-hydroxyvitamin D in patients with type 2 diabetes mellitus (T2DM) in Riyadh, Saudi Arabia. METHODS An interview based cross-sectional study was conducted on 606 patients with type 2 diabetes, aged 30-75 years, visiting primary health care centers. Blood samples were collected for measuring HbA1c, 25(OH)D and bone and lipid markers. Multivariable linear regression analysis was conducted to explore the association between HbA1c and 25(OH)D. RESULTS The mean (±SD) levels for HbA1c and 25(OH) D were 7.69 (±1.77) and 44.28 (±23.06), respectively. Around 55% of patients had uncontrolled HbA1c (>7.0), whereas vitamin D deficiency (<50 nmol/L) was found in 52.3% (=317). Multiple linear regression analysis found that a unit increase in vitamin D levels and parathyroid hormone levels was associated with -0.17 (-0.02, -0.01, p < 0.001) and -0.20 (-2.66, -1.18, p < 0.001) unit decrease in levels of HbA1c, respectively. Similarly, increasing age was associated with -0.15 (-0.01, -0.04, p = 0.002) unit decrease in HbA1c levels, whereas unit increases in serum alkaline phosphatase, calcium and diabetes duration were associated with 0.22 (0.01, 0.02, p < 0.001), 0.14 (1.03, 3.88, p = 0.001) and 0.26 (0.42, 0.78, p < 0.001) unit increase in HbA1c levels, respectively. CONCLUSION HbA1c levels are associated with 25-hydroxyvitamin D levels. For better control of HbA1c levels, it is important to maintain 25-hydroxyvitamin D level and bone markers within normal range.
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Affiliation(s)
- AlJohara M AlQuaiz
- Reserach Chairs Program, Princess Nora Bent Abdullah Chair for Women’s Health Research, King Saud University, Riyadh 231831, Saudi Arabia; (A.M.A.); (K.M.A.); (M.A.F.)
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia; (A.A.A.); (M.A.B.); (A.J.)
| | - Abdullah A Alrasheed
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia; (A.A.A.); (M.A.B.); (A.J.)
| | - Ambreen Kazi
- Reserach Chairs Program, Princess Nora Bent Abdullah Chair for Women’s Health Research, King Saud University, Riyadh 231831, Saudi Arabia; (A.M.A.); (K.M.A.); (M.A.F.)
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia; (A.A.A.); (M.A.B.); (A.J.)
- Correspondence: ; Tel.: +966-(1)-4692716
| | - Mohammad Ali Batais
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia; (A.A.A.); (M.A.B.); (A.J.)
| | - Khaled M Alhabeeb
- Reserach Chairs Program, Princess Nora Bent Abdullah Chair for Women’s Health Research, King Saud University, Riyadh 231831, Saudi Arabia; (A.M.A.); (K.M.A.); (M.A.F.)
| | - Amr Jamal
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia; (A.A.A.); (M.A.B.); (A.J.)
| | - Mona A Fouda
- Reserach Chairs Program, Princess Nora Bent Abdullah Chair for Women’s Health Research, King Saud University, Riyadh 231831, Saudi Arabia; (A.M.A.); (K.M.A.); (M.A.F.)
- Endocrinology Division, Department of Medicine, College of Medicine, King Saud University, Riyadh 7065, Saudi Arabia
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Al‐Mohaissen MA, Lee T, Alamri AF. Vitamin D levels, prediabetes risk and hemoglobin A1c levels in young non-diabetic Saudi women. J Diabetes Investig 2020; 11:1344-1351. [PMID: 32017439 PMCID: PMC7477525 DOI: 10.1111/jdi.13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/24/2020] [Accepted: 02/02/2020] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION Vitamin D levels are negatively correlated with prediabetes risk and hemoglobin A1c levels in individuals with prediabetes. The data are, however, scarce and inconsistent among different populations. We aimed to assess the association of vitamin D with prediabetes risk and hemoglobin A1c levels in young Saudi women with normoglycemia and prediabetes. MATERIALS AND METHODS We analyzed the data of individuals without diabetes (without diabetes history and hemoglobin A1c <6.4%) from the Princess Nourah bint Abdulrahman University's non-communicable diseases student registry. Demographic data, anthropometric and blood pressure measurements, and hemoglobin A1c and vitamin D results were retrieved and analyzed. RESULTS In total, 345 participants were included in the analysis. The prediabetes status showed no association with vitamin D levels, but it was significantly associated with the participants' weight and body mass index. Additionally, there was no correlation between the levels of vitamin D and hemoglobin A1c across the whole population, even after correction for body mass index. However, in the body mass index subgroups, when individuals with potentially harmful levels of vitamin D (>125 nmol/L) were excluded, a positive association was detected between vitamin D and hemoglobin A1c levels in the underweight individuals. Hemoglobin A1c values showed a positive correlation only with bodyweight and body mass index. CONCLUSIONS Vitamin D levels did not predict prediabetes status and showed no correlation with hemoglobin A1c levels in this population. Vitamin D levels' effect on the risk of prediabetes might be small compared with other well-established risk factors, such as obesity.
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Affiliation(s)
- Maha A Al‐Mohaissen
- Department of Clinical Sciences, CardiologyPrincess Nourah Bint Abdulrahman UniversityRiyadhSaudi Arabia
- Princess Nourah Bint Abdulrahman University Cardiovascular Disease in Women Research ChairRiyadhSaudi Arabia
| | - Terry Lee
- Center for Health Evaluation and Outcome SciencesVancouverBritish ColumbiaCanada
| | - Ali Faris Alamri
- Department of Family MedicineKing Abdullah bin Abdulaziz University HospitalPrincess Nourah bint Abdulrahman UniversityRiyadhSaudi Arabia
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Mohsin S, Baniyas MM, AlDarmaki RS, Tekes K, Kalász H, Adeghate EA. An update on therapies for the treatment of diabetes-induced osteoporosis. Expert Opin Biol Ther 2019; 19:937-948. [PMID: 31079501 DOI: 10.1080/14712598.2019.1618266] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Currently, 424 million people aged between 20 and 79 years worldwide are diabetic. More than 25% of adults aged over 65 years in North America have Type 2 diabetes mellitus (DM). Diabetes-induced osteoporosis (DM-OS) is caused by chronic hyperglycemia, advanced glycated end products and oxidative stress. The increase in the prevalence of DM-OS has prompted researchers to develop new biological therapies for the management of DM-OS. Areas covered: This review covered the current and novel biological agents used in the management of DM-OS. Data were retrieved from PubMed, Scopus, American Diabetes Association and International Osteoporosis Foundation websites, and ClinicalTrials.gov. The keywords for the search included: DM, osteoporosis, and management. Expert opinion: Several biological molecules have been examined in order to find efficient drugs for the treatment of DM-OS. These biological agents include anti-osteoporosis drugs: net anabolics (parathyroid hormone/analogs, androgens, calcilytics, anti-sclerostin antibody), net anti-resorptive osteoporosis drugs (calcitonin, estrogen, selective estrogen receptor modulators, bisphosphonates, RANKL antibody) and anti-diabetic drugs (alpha glucosidase inhibitors, sulfonylureas, biguanides, meglitinides, thiazolidinediones, GLP-1 receptor agonists, dipeptidylpeptidase-4 inhibitors, sodium glucose co-transporter-2 inhibitors, insulin). Biological medications that effectively decrease hyperglycemia and, at the same time, maintain bone health would be an ideal drug/drug combination for the treatment of DM-OS.
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Affiliation(s)
- Sahar Mohsin
- a Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - May Myh Baniyas
- a Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - Reem Smh AlDarmaki
- a Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
| | - Kornélia Tekes
- b Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University , Budapest , Hungary
| | - Huba Kalász
- c Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Ernest A Adeghate
- a Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
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25-Hydroxyvitamin D Status and Risk for Colorectal Cancer and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Epidemiological Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020127. [PMID: 28134804 PMCID: PMC5334681 DOI: 10.3390/ijerph14020127] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 12/22/2022]
Abstract
Epidemiological evidence suggests an association between low vitamin D status and risk for various outcomes including cardiovascular diseases, cancer, and type 2 diabetes mellitus (T2DM). Analyzing serum 25-hydroxyvitamin D [25(OH)D] is the most established means to evaluate an individual's vitamin D status. However, cutoff values for 25(OH)D insufficiency as well as for optimal 25(OH)D levels are controversial. This systematic review critically summarizes the epidemiological evidence regarding 25(OH)D levels and the risk for colorectal cancer and T2DM. The meta-analytical calculation revealed a pooled relative risk (RR) of 0.62 (CI 0.56-0.70; I² = 14.7%) for colorectal cancer and an RR of 0.66 (CI 0.61-0.73; I² = 38.6%) for T2DM when comparing individuals with the highest category of 25(OH)D with those in the lowest. A dose-response analysis showed an inverse association between 25(OH)D levels and RR for both outcomes up to concentrations of about 55 ng/mL for colorectal cancer and about 65 ng/mL for T2DM. At still higher 25(OH)D levels the RR increases slightly, consistent with a U-shaped association. In conclusion, a higher 25(OH)D status is associated with a lower risk for colorectal cancer and T2DM; however, this advantage is gradually lost as levels increase beyond 50-60 ng/mL.
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