Bone remodeling in men with type 2 diabetes: is it just the same thing as in women?

Poster (download) Olga Fazullina1, Vadim Klimontov2, Maksim Dashkin31RICEL – Branch of IC&G SB RAS, fazullina@ngs.ru2RICEL – Branch of IC&G SB RAS, klimontov@mail.ru3RICEL – Branch of IC&G SB RAS, mdashkin@invitro.ru Background and aim: The mechanisms of reducing the bone mineral density (BMD) in men with type 2 diabetes are poorly understood. The aim of our study was to determine the relationships between the markers of bone remodeling and BMD in men with type 2 diabetes. Materials and Methods: The study included 59 men with type 2 diabetes, from 50 to 75 years of age. BMD and T-score were determined by dual-energy X-ray absorptiometry. A serum levels of parathyroid hormone (PTH), free testosterone, osteocalcin, osteoprotegerin, sclerostin, and urinary excretion of C-terminal telopeptides of type I collagen (CTX-I) were determined by ELISA. Control group comprised of 21 healthy subjects with normal BMD, matched by sex and age. Results: A reduced BMD was revealed in 29 patients, including 4 individuals with osteoporosis and 25 subjects with osteopenia. The levels of osteocalcin were decreased and the levels of osteoprotegerin and sclerostin were increased in observed diabetic subjects as compared to control (p=0.02, p<0.001 and p=0.02 respectively). The excretion of CTX-1 was reduced in patients with diabetes (p<0.001). There were no differences in PTH and free testosterone concentrations between control and diabetic subjects. In stepwise multivariate regression analysis, sclerostin was the most significant predictor for lumbar spine T-score (ОІ=0.496, R2=0.23, p=0.00007), the level of PTH influenced the femoral neck T-score (ОІ=-0.29, R2=0.26, p=0.005). Conclusions: The obtained results suggest that the bone remodeling in men with type 2 diabetes is reduced due to the inhibition of osteoblastogenesis and decrease in the bone formation and resorption.

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The prevalence and the risk factors for low-energy fractures in women with type 2 diabetes

Poster (download) Olga Fazullina1, Vadim Klimontov21RICEL – Branch of IC&G SB RAS, fazullina@ngs.ru2RICEL – Branch of IC&G SB RAS, klimontov@mail.ru Background and aim: The modeling of the risk of osteoporosis-related fractures in women with type 2 diabetes is important issue for medicine. The aim of our study was to determine the prevalence and the risk factors for low-energy fractures in postmenopausal women with type 2 diabetes. Materials and Methods: The study included 236 postmenopausal women with type 2 diabetes, from 50 to 75 years of age. Bone mineral density (BMD), T-score and total body composition were determined by dual-energy X-ray absorptiometry. Results: A reduced BMD was revealed in 150 women, including 45 individuals with osteoporosis and 105 subjects with osteopenia. A history of fractures occurred in 72 patients (30.5%). Low-energy fractures were observed in the groups of osteopenia (n=8) and osteoporosis (n=14). The most common localization of low-energy fractures was the radius (57.9% of all low-energy fractures), and proximal femur (36.8%). Women with low-energy fractures were older (p<0.001), had a lower body mass index (p<0.001), longer duration of insulin therapy and duration of postmenopause (p=0.01 and p<0.001 respectively). When analyzing the total body composition women with low-energy fractures had less total fat mass, abdominal and hip fat mass, and less lean mass (all p<0.001). In discriminant analysis, the duration of type 2 diabetes was the most reliable factor associated with low-energy fractures (model parameters: p=0.01; F=6.2; recognition accuracy 87%). Conclusions: The age, duration of diabetes, postmenopause and insulin treatment, as well as body composition parameters (fat mass and lean mass), should be taken into consideration when modeling the risk of low-grade fractures in postmenopausal women with type 2 diabetes.

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Thyroid dysfunction is associated with osteoporosis in patients with Hodgkin’s lymphoma

Poster (download) Mariya S. Voytko1, Vadim V. Klimontov2, Tatyana I. Pospelova3, Olga N. Fazullina4, Alexander I. Autenshlyus51Novosibirsk State Medical University, voytko.marie@yandex.ru2Research Institute of Clinical and Experimental Lymphology, klimontov@mail.ru3Novosibirsk State Medical University, post_gem@mail.ru4Research Institute of Clinical and Experimental Lymphology, fazullina@ngs.ru5Novosibirsk State Medical University, post_gem@mail.ru Background and Aim: Radiation therapy (RT) is a cornerstone component of the treatment for many patients with Hodgkin\’s lymphoma (HL). Current treatment options for HL are mostly effective, but may have a negative pronounced damaging effect on some organs. Specifically, RT can induce thyroid dysfunction and decrease in bone mineral density (BMD). The aim of the study was to assess the prevalence of thyroid dysfunction in HL survivors and estimate its effect on BMD. Methods: The study included 160 patients with HL, from 18 to 65 years of age (median 42 years), observed in Hematology Center of Novosibirsk. The disease was staged according to the Ann Arbor staging system; 71 patients had limited stage (I-II) and 84 patients had advanced stage disease (stage III to IV). All subjects received first-line regimens. Neck and supraclavicular RT was performed in 96 (60%) individuals; the total dose was 30 Gy in 84 patients and 36 Gy in 11 ones. Thyroid hormones were measured by enzyme immunoassays. The BMD was assessed by dual-energy X-ray absorptiometry. Statistical data processing was performed using STATISTICA (StatSoft, Inc., USA). Results: The changes in thyroid function were revealed in 40 (25%) patients. Among them, primary hypothyroidism was verified in 30 subjects, including 18 individuals with subclinical hypothyroidism. Ten patients had central hypothyroidism. Thirty two patients had neck and supraclavicular RT in their anamnesis. In this subgroup, hypothyroidism was observed in 22 subjects with total focal dose of 30 Gy and in 8 subjects with the total focal dose of 36 Gy. The decrease in BMD was revealed in 76 HL subjects (47.5%), 43 of them diagnosed as having osteoporosis. The decline in BMD was more frequent in patients with hypothyroidism as compared to those without (П‡2=13.4, СЂ<0.001). Conclusion: Hypothyroidism is associated with decrease in BMD in patients with HL.

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Opportunities of Trabecular Bone Score to Evaluate Ankylosing Spondilitis Structural Progression in Young Male Patients

Poster (download) Kolpakov Konstantin1, Korolev Maxim2, Letyagina Elena31Laboratory of Connective Tissue Disease, RICEL – Branch of ICG SB RAS Novosibirsk, Russian Federation, elmad95@mail.ru2Laboratory of Connective Tissue Disease, RICEL – Branch of ICG SB RAS Novosibirsk, Russian Federation, kormax@bk.ru3Laboratory of Connective Tissue Disease, RICEL – Branch of ICG SB RAS Novosibirsk, Russian Federation, elena_letyagina@list.ru Ankylosing spondylitis (AS) is a chronic progressive systemic inflammatory disease, with a primary lesion of the spine and sacroiliac joints characterized by simultaneously running processes of osteogenesis (syndesmophytes) and osteoresorption (osteoporosis). The aim of this work is to investigate trabecular bone score (TBS) correlation with signs of structural progression of AS in the males before 50. Fourteen AS male patients before 50 without osteoporosis are included in investigation. The relationships between TBS, the Kellgren sacroiliitis stage, and BMD indices in different parts of the skeleton were studied using Spearman correlation analysis. A strong negative correlation was found between TBS and the X-ray stage of Kellgren sacroiliitis (r = -0.69; p <0.05) in men before 50 with AS. BMD does not reflect the degree of structural disturbances and the risks of spinal fractures in men before 50 with AS in the absence of other causes of secondary osteoporosis.

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