Assessment of bone remodeling in patients with type 2 diabetes mellitus


  • Sain Sattar Safarova Azerbaijan Medical University, Baku, Azerbaijan Republic,



diabetes mellitus, bone tissue


Despite higher femoral neck and lumbar spine bone mineral density (BMD), individuals with type 2 diabetes mellitus (DM2) have 1,5-2 times increased fracture risk than in a healthy population. These data suggest that some indicators may be more informative regarding the prediction of low-trauma fractures risk, which observed in patients with diabetes mellitus, and BMD measurement does not reflect in essence the real trend towards the development of bone remodeling disorders in these patients.

Aim: to identify complex interdependencies between the bone mineral and organic components and the risk of low-trauma fractures associated with metabolic changes in DM2.

Materials and methods. A cross-sectional study was conducted in patients diagnosed with DM2 (n = 137); the control group consisted of 82 individuals. Calciotropic hormones, serum levels of bone remodeling markers and X-ray densitometry were studied in all the patients.

Results. Patients with DM2 had lower P1NP and b-CTx values, reflecting a slower metabolism of bone tissue compared to the control group. The results of densitometry revealed no significant differences in BMD between the patients with DM2 and control.

Conclusions. High rate of bone remodeling was found at the elevated values of parathyroid hormone with a predominance of bone resorption, which is confirmed by a positive correlation between parathyroid hormone level and the serum biochemical marker of bone resorption. There is a relationship between DM2 duration and a decrease in BMD, which is the most pronounced in men aged up to 50 years.



Vestergaard, P., Rejnmark, L., & Mosekilde, L. (2009) Diabetes and its complications and their relationship with risk of fractures in type 1 and 2 diabetes. Calcif Tissue Int., 84(1), 45–55. doi: 10.1007/s00223-008-9195-5.

Becerra-Tomás, N., Estruch, R., Bulló, M., Casas, R., Díaz-López, A., Basora, J., et al. (2014) Increased Serum Calcium Levels and Risk of Type 2 Diabetes in Individuals at High Cardiovascular Risk. Diabetes Care., 37(11), 3084–3091. doi: 10.2337/dc14-0898.

Lederer, E. (2014) Regulation of serum phosphat. J Physiol., 592(18), 3985–3995. doi: 10.1113/jphysiol.2014.273979.

Yamamoto, M., & Sugimoto, T. (2016) Advanced Glycation End Products, Diabetes, and Bone Strength. Curr Osteoporos Rep., 14(6), 320–326. doi: 10.1007/s11914-016-0332-1.

Liamis, G., Liberopoulos, E., Barkas, F., & Elisaf, M. (2014) Diabetes mellitus and electrolyte disorders. World J Clin Cases., 2(10), 488–496. doi: 10.12998/wjcc.v2.i10.488.

Fisher, A., Srikusalanukul, W., Fisher, L., & Smith, P. N. (2017) Lower serum P1NP/β-CTX ratio and hypoalbuminemia are independently associated with osteoporotic nonvertebral fractures in older adults. ClinInterv Aging. 12, 1131–1140. doi: 10.2147/CIA.S141097.

Nakashima, A., Yokoyama, K., Yokoo, T., & Urashima, M. (2016) Role of vitamin D in diabetes mellitus and chronic kidney disease. World J Diabetes., 7(5), 89–100. doi: 10.4239/wjd.v7.i5.89.

Moisa, S. S. (2014) Calcitonin and Parathyrin are Glucoregulating Hormones. J Mol Genet Med, S1, 024. doi: 10.4172/1747-0862.S1-024.

Hinton, P. S. (2016) Role of reduced insulin-stimulated bone blood flow in the pathogenesis of metabolic insulin resistance and diabetic bone fragility. Medical hypotheses, 93, 81–86. doi: 10.1016/j.mehy.2016.05.008.

Jørgensen, H. S., Winther, S., Bøttcher, M., Hauge, E., Rejnmark, L., Svensson, M., & Ivarsen, P. (2017) Bone turnover markers are associated with bone density, but not with fracture in end stage kidney disease: a cross-sectional study. BMC Nephrol., 18, 284. doi: 10.1186/s12882-017-0692-5

How to Cite

Safarova SS. Assessment of bone remodeling in patients with type 2 diabetes mellitus. Zaporozhye medical journal [Internet]. 2019Feb.8 [cited 2024Feb.21];(1). Available from:



Original research