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Diabetes Care. 2018 Sep;41(9):1901-1908. doi: 10.2337/dc18-0849. Epub 2018 Jul 12.

Biochemical Markers of Bone Turnover and Risk of Incident Diabetes in Older Women: The Cardiovascular Health Study.

Author information

1
Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
2
University of Washington, Seattle, WA.
3
Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
4
Beth Israel Deaconess Medical Center, Boston, MA.
5
University of California San Diego, San Diego, CA.
6
Brigham and Women's Hospital, Boston, MA.
7
University of Miami, Miami, FL.
8
The New York Academy of Medicine, New York, NY.
9
University of Vermont, Burlington, VT.
10
Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY jorge.kizer@einstein.yu.edu.

Abstract

OBJECTIVE:

To investigate the relationship of osteocalcin (OC), a marker of bone formation, and C-terminal cross-linked telopeptide of type I collagen (CTX), a marker of bone resorption, with incident diabetes in older women.

RESEARCH DESIGN AND METHODS:

The analysis included 1,455 female participants from the population-based Cardiovascular Health Study (CHS) (mean [SD] age 74.6 [5.0] years). The cross-sectional association of serum total OC and CTX levels with insulin resistance (HOMA-IR) was examined using multiple linear regression. The longitudinal association of both markers with incident diabetes, defined by follow-up glucose measurements, medications, and ICD-9 codes, was examined using multivariable Cox proportional hazards models.

RESULTS:

OC and CTX were strongly correlated (r = 0.80). In cross-sectional analyses, significant or near-significant inverse associations with HOMA-IR were observed for continuous levels of OC (β = -0.12 per SD increment; P = 0.004) and CTX (β = -0.08 per SD; P = 0.051) after full adjustment for demographic, lifestyle, and clinical covariates. During a median follow-up of 11.5 years, 196 cases of incident diabetes occurred. After full adjustment, both biomarkers exhibited inverse associations with incident diabetes (OC: hazard ratio 0.85 per SD [95% CI 0.71-1.02; P = 0.075]; CTX: 0.82 per SD [0.69-0.98; P = 0.031]), associations that were comparable in magnitude and approached or achieved statistical significance.

CONCLUSIONS:

In late postmenopausal women, lower OC and CTX levels were associated with similarly increased risks of insulin resistance at baseline and incident diabetes over long-term follow-up. Further research to delineate the mechanisms linking abnormal bone homeostasis and energy metabolism could uncover new approaches for the prevention of these age-related disorders.

PMID:
30002202
PMCID:
PMC6105330
DOI:
10.2337/dc18-0849
[Indexed for MEDLINE]
Free PMC Article

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