2023, Vol. 27 ›› Issue (8): 1156-1160

Comparison of bone metabolism markers between type 2 diabetes mellitus and non-type 2 diabetes mellitus patients with hip fracture

Sun Jiajia, Zhu Haidi, Lu Yun, Zhang Kai   

Abstract: BACKGROUND: Hip fracture and type 2 diabetes mellitus are common and frequently-occurring diseases in older adults and their internal relationship needs further studies.
OBJECTIVE: To compare the levels of bone metabolism markers between type 2 diabetes mellitus and non-type 2 diabetes mellitus patients with hip fracture.
METHODS: Total 743 patients with hip fracture from August 2014 to August 2020 were enrolled in this study. According to the presence or absence of diabetes history, they were further divided into type 2 diabetes mellitus group (T2DM group, n=118) and non-type 2 diabetes mellitus group (non-T2DM group, n=625). Biochemical parameters (fasting blood glucose, alkaline phosphatase, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, blood calcium, and blood phosphorus) and bone metabolism parameters (total serum procollagen type N-terminal propeptide, the age-related type I cross linked C-telopeptide and 25-hydroxyvitamin D) were collected and compared. The correlation between fast blood glucose and triglyceride and bone metabolism parameters was calculated by the Spearman correlation analysis.
RESULTS AND CONCLUSION: The fast blood glucose and triglyceride levels in the T2DM group were significantly higher than those in the non-T2DM group. In addition, the total serum procollagen type N-terminal propeptide (P=0.017) and total serum procollagen type N-terminal propeptide (P=0.007) levels in the T2DM group were significantly lower than those in the non-T2DM group. The correlation coefficients between fasting blood glucose and age-related type I cross linked C-telopeptide, between fasting blood glucose and total serum procollagen type N-terminal propeptide, between triglyceride and total serum procollagen type N-terminal propeptide, and between blood calcium and 25-hydroxyvitamin D were -0.124 (P < 0.001), -0.174 (P < 0.001), 0.075 (P=0.04), and 0.108 (P=0.003), respectively. This cross-sectional study indicated that there is a low bone turnover state (both bone formation and bone resorption) in patients with type 2 diabetes mellitus after hip fractures and the fasting blood glucose levels is negatively correlated with total serum procollagen type N-terminal propeptide and age-related type I cross linked C-telopeptide levels. In addition, good glucose control may be beneficial to bone metabolism and prevent from delayed fracture healing after hip fracture.
Key words: hip fracture, osteoporosis, type 2 diabetes mellitus, bone metabolism marker, fracture healing