This article is more than 5 years old. Information may no longer be current.
Vertebral fractures, cortisol secretion linked in postmenopausal women with type 2 diabetes
Click Here to Manage Email Alerts
Vertebral fractures were associated with cortisol secretion and sensitivity in postmenopausal women with type 2 diabetes, according to research published in the Journal of Clinical Endocrinology & Metabolism.
“This study suggests … the prevalence of vertebral facture is increased in spite of an increased bone mineral density and bone turnover is reduced … the presence of vertebral fracture is associated with the degree of cortisol secretion and with the sensitizing variant of N363S polymorphism of the glucocorticoid receptor,” the researchers wrote.
Volha V. Zhukouskaya, MD, PhD, of the unit of endocrinology and metabolic diseases, University of Milan, Italy, and colleagues studied 99 postmenopausal women (mean age, 65.7 ± 7.3 years) with controlled type 2 diabetes and 107 (mean age, 64.5 ± 8.2 years) without.
The researchers assessed osteocalcin (OC), C-terminal telopeptide of type-I-collagen (beta-CTX), adrenocorticotropic hormone (ACTH), cortisol after dexamethasone suppression test (F-1mgDST) and BclI and N363S single nucleotide polymorphisms (SNPs) of the glucocorticoid (GC) receptor. Spinal (LS) and femoral (FN) bone mineral density (BMD) were measured by dual X-ray absorptiometry and vertebral facture (VFx) by radiography.
Compared with controls, participants with type 2 diabetes had increased VFx prevalence (20% vs. 34.3%; P=.031), BMD (z scores: LS 0.16 ± 1.28 vs. 0.78 ± 1.43, P=.001; FN -0.03 ± 0.87 vs. 0.32 ± 0.98, P=.008) and F-1mgDST (1.06 ± 0.42 vs. 1.21 ± 0.44 mcg/dL, 29.2 ± 1.2 vs. 3.3 ± 1.2 nmol/L respectively; P=0.01); but respective decreases were seen for OC (10.6 ± 6.4 vs. 4.9 ± 3.2 ng/ml; P<.0001) and beta-CTX (0.28 ± 0.12 vs. 0.14 ± 0.08 ng/ml; P<.0001).
Participants with type 2 diabetes or controls with fractures demonstrated increased prevalence of sensitizing N363S SNPs (20% and 17.6%, respectively) than not fractured subjects (3.4% and 3.1%, respectively; P=.02 for both comparisons); similar BclI SNPs prevalence was observed.
VFx presence was associated with the sensitizing variant of N363S SNPs both in controls (OR=10.6; 95% CI, 1.8–63.3) and participants with diabetes (OR=12.5; 95% CI, 1.8–88.7). Only in participants with diabetes was VFx associated with 1mg-DST levels (OR=2.1; 95% CI, 1.1–4.1).
“Further studies could be designed to ascertain if the parameters of cortisol secretion and sensitivity may be used for personalizing the therapy in type 2 diabetes-related osteoporosis,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures
Click Here to Manage Email Alerts