Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus.
Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus.
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DOI：
10.3389/fendo.2021.788107
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发表时间：
2021
影响因子：
5.2
通讯作者：
Armamento-Villareal R
中科院分区：
文献类型：
--
作者：
Joad S;Ballato E;Deepika F;Gregori G;Fleires-Gutierrez AL;Colleluori G;Aguirre L;Chen R;Russo V;Fuenmayor Lopez VC;Qualls C;Villareal DT;Armamento-Villareal R
新出现的数据表明，2型糖尿病（T2 D）与骨折风险增加相关，尽管骨矿物质密度（BMD）相对正常或增加。尽管T2 D患者骨脆性的机制是多因素的，但血糖控制是否在产生骨代谢损害中起重要作用仍不清楚。本研究的目的是确定血红蛋白A1 c（A1 c）阈值水平，T2 D男性患者骨转换开始降低。基线数据的横断面分析来自217名男性，年龄35-65岁，无论是否存在性腺功能减退症或T2 D，他们参加了2项临床试验。获得以下数据：A1 c（HPLC法），睾酮和雌二醇（LC/MS法），骨转换标志物骨钙素[OC]、C-末端肽[CTx]和硬化素（ELISA法），BMD（DXA法）。根据A1 c将患者分为4类（I组：<6%，II组：6.0- 6.4%，III组：6.5- 6.9%，IV组：≥7%）。使用非线性回归和通过ANOVA进行的不同A1 c类别之间的组比较将阈值模型拟合至数据。阈值模型和非线性回归显示，A1 c截止值为7.0，在所有A1 c的选择中，产生最小的平方误差和。骨转换标志物的比较显示，与其他组相比，IV组（A1 c ≥7%）的OC（p = 0.002）和CTx（p = 0.0002）相对较低。对T2 D男性患者（n = 94）的分析显示，与A1 c <7%的患者相比，A1 c ≥7%的患者OC（p=0.001）和CTx（p=0.002）相对较低。即使在调整药物和糖尿病持续时间后，组间的显著性仍然存在。对我们整个研究人群的分析显示，A1 c水平的折点为7%或更高与骨转换降低相关。同样，在T2 D男性中，A1 c ≥7%与骨转换低相关。
Emerging data suggest that type 2 diabetes mellitus (T2D) is associated with an increased risk for fractures despite relatively normal or increased bone mineral density (BMD). Although the mechanism for bone fragility in T2D patients is multifactorial, whether glycemic control is important in generating this impairment in bone metabolism remains unclear. The purpose of our study is to identify a hemoglobin A1c (A1c) threshold level by which reduction in bone turnover begins in men with T2D. A cross-sectional analysis of baseline data was obtained from 217 men, ages 35–65, regardless of the presence or absence of hypogonadism or T2D, who participated in 2 clinical trials. The following data were obtained: A1c by HPLC, testosterone and estradiol by LC/MS, bone turnover markers Osteocalcin [OC], C-terminal telopeptide [CTx], and sclerostin by ELISA, and BMD by DXA. Patients were grouped into 4 categories based of A1c (group I: <6%, group II: 6.0–6.4%, group III: 6.5–6.9%, and group IV: ≥7%). Threshold models were fit to the data using nonlinear regression and group comparisons among the different A1c categories performed by ANOVA. Threshold model and nonlinear regression showed an A1c cut-off of 7.0, among all choices of A1cs, yields the least sum of squared errors. A comparison of bone turnover markers revealed relatively lower OC (p = 0.002) and CTx (p = 0.0002) in group IV (A1c ≥7%), compared to the other groups. An analysis of men with T2D (n = 94) showed relatively lower OC (p=0.001) and CTx (p=0.002) in those with A1c ≥7% compared to those with <7%, respectively. The significance between groups persisted even after adjusting for medications and duration of diabetes. An analysis across our entire study population showed a breakpoint A1c level of 7% or greater is associated with lower bone turnover. Also in men with T2D, an A1c ≥7% is associated with low bone turnover.
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影响因子：
6.2
作者：
Lee, Richard H.;Sloane, Richard;Colon-Emeric, Cathleen
通讯作者：
Colon-Emeric, Cathleen
影响因子：
16.2
作者：
Schwartz AV;Margolis KL;Sellmeyer DE;Vittinghoff E;Ambrosius WT;Bonds DE;Josse RG;Schnall AM;Simmons DL;Hue TF;Palermo L;Hamilton BP;Green JB;Atkinson HH;O'Connor PJ;Force RW;Bauer DC
通讯作者：
Bauer DC
DOI：
10.1016/j.ecl.2013.09.004
发表时间：
2014-03-01
影响因子：
4.5
作者：
Kurra, Salila;Fink, Dorothy A.;Siris, Ethel S.
通讯作者：
Siris, Ethel S.
影响因子：
6.2
作者：
Nilsson, Anna G.;Sundh, Daniel;Lorentzon, Mattias
通讯作者：
Lorentzon, Mattias
影响因子：
3.7
作者：
Aguirre LE;Colleluori G;Robbins D;Dorin R;Shah VO;Chen R;Jan IZ;Qualls C;Villareal DT;Armamento-Villareal R
通讯作者：
Armamento-Villareal R