Osteocalcin and type 2 diabetes mellitus

Berisha-Muharremi, Venera (2014) Osteocalcin and type 2 diabetes mellitus. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Introduction: From year 2007. in vitro and in vivo studies have suggested a role of undercarboxylated osteocalcin (ucOC) in glucose and energy metabolism. ----- Aims: The aim of the study was to investigate the relationship of ucOC level and blood glucose (BG) control in newly diagnosed type 2 diabetes and its change with BG control improvement. ----- Subjects and methods: Fifty seven newly diagnosed type 2 diabetic patients had a consultation about life style changes on visit 1, no BG regulation medication was prescribed. The final visit (2) was three months later. Samples for parameters of BG metabolism and bone turnover were collected on visit 1 and 2. ----- Results: Forty seven patients completed the study. Thirty two (56%) patients reached the target HbA1c (≤7%). No correlation of ucOC and HbA1c and FBG was observed. Median HbA1c and FBG changed significantly (8.0 to 6.5%; 9.0 to 7.0 mmol/L resp.; Wilcoxon signed rank test p<0.001), ucOC was slightly but not significantly lower (2.0 to 1.4 mcg/L; p=0.465). No correlation between differences in HbA1c and ucOC between Visits 1 and 2 was revealed. There was a significant change in HOMA%B but not HOMA IR, not correlated to ucOC. ----- Conclusion: This study failed to prove the relationship between blood glucose regulation and ucOC level. However, it does not exclude it, so further research is needed. The fact that as much as 56% patients achieved the target HbA1c with no medication, challenges most BG control guidelines.

Abstract in Croatian

Uvod: Od 2007. je objavljeno nešto in vitro i in vivo ispitivanja koja ukazuju na moguću ulogu podkarboksiliranog osteokalcina (ucOC) u energetskom metabolizmu i glukoregulaciji. ----- Ciljevi: Cilj studije je ispitati odnos ucOC i kontrole glukoze u plazmi (GUP) u osoba s novootkrivenom šećernom bolešću tipa 2 i promjenu s poboljšanjem glukoregulacije. ----- Pacijenti i metode: Pedeset sedam osoba s novootkrivenom šećernom bolešću tipa 2 je dobilo savjetovanje o promjeni stila života, nije prepisana medikamentozna terapija za kontrolu GUP na pregledu 1. Zaključni pregled - 2 je bio tri mjeseca kasnije. Uzorci za određivanje parametara glukoregulacije i koštane pregradnje su uzeti na pregledu 1 i 2. ----- Rezultati: Četrdeset sedam ispitanika je kompletiralo ispitivanje. Trideset dvoje (56%) ispitanika je postiglo ciljnu razinu HbA1c (≤7%). Nije uočena povezanost ucOC sa HbA1c i GUP. HbA1c i GUP su se značajno promijenili (median 8,0 na 6,5%; 9,0 na 7,0 mmol/L resp.; Wilcoxon signed rank test p<0,001), ucOC je u drugoj posjeti bio neznačajno niži (2,0 na 1,4 mcg/L; p=0,465). Nije uočena povezanost razlika HbA1c i ucOC između 1. i 2. posjete. Indeks HOMA%B, no ne i HOMA IR, je pokazao značajnu promjenu, bez povezanosti s ucOC. ----- Zaključak: ovo ispitivanje nije dokazalo povezanost regulacije glikemije i razine ucOC, međutim niti je isključuje, pa su potrebna daljnja ispitivanja. Činjenica da je čak 56% pacijenata postiglo ciljnu glukoregulaciju po HbA1c je izazov većini današnjih smjernica za glukoregulaciju.

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