Risk Factors of Elderly Type 2 Diabetes Mellitus Complicated with Osteoporosis and Effects of Vitamin K1 on Bone Mineral Density and Insulin Resistance
American Journal of Life Sciences
Volume 7, Issue 1, February 2019, Pages: 12-16
Received: Jan. 22, 2019;
Published: Mar. 8, 2019
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Lei Sun, Department of Orthopedics, Binzhou People's Hospital, Binzhou City, P.R.China
Hongjian Yu, Department of Orthopedics, Binzhou People's Hospital, Binzhou City, P.R.China
Donghui Tian, Department of Neurology, Binzhou People's Hospital, Binzhou City, P.R.China
Rui Zhang, Technical Office, People's Court of Bincheng District, Binzhou City, P.R.China
Wenjing Du, Technical Office, Binzhou Intermediate People's Court, Binzhou City, P.R.China
Aim: To analyze the bone mineral density (BMD) changes of type 2 diabetes mellitus (T2DM) after being complicated with osteoporosis (OP) and their correlations with multiple risk factors. Methods: 240 cases of elderly T2DM patients were divided into an OP group and a non-OP group according to the BMD values. The results were subjected to correlation analyses. Thereafter the 120 patients in the OP group were randomly divided into three groups to be treated with alfacalcidol (group A), vitamin K1 (group B) and alfacalcidol plus vitamin K1 (group C) continuously for 12 months. The BMD, FBG levels, fasting insulin (FINS) levels, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) levels were measured 0, 6 and 12 months after administration. The heights, weights, BMI and HOMA-insulin resistance (HOMA-IR) of the patients were measured by designated personnel. Results: The patients in the OP group were of older age, longer disease course, lower BMD, and higher serum phosphorus than those in the non-OP group. The results of the two groups differed significantly (P< 0.05). The BMD of T2DM patients was negatively correlated with age, disease course, ALP and HbA1c and positively correlated with BMI. All the treatment methods elevated the BMD values of the three groups after 12 months (P<0.05 or P<0.01), and those of group C were elevated more significantly than those of group A and group B (P<0.05 or P<0.01). Although the number of lumbar vertebrae L1-L4 and ectotrochanter of group A patients were higher than that of group B patients after being treated for 3 months (P<0.01), the results of the two groups did not differ significantly (P> 0.05) 12 months after treatment. Conclusions: Old age, low BMI, long disease course, poor blood glucose control and high serum ALP are the risk factors leading to T2DM complicated with OP. However, vitamin K1, which increased the BMD of T2DM patients and boosted insulin resistance, could be combined with alfacalcidol and calcium supplement owing to the lack of abnormal blood clotting mechanism after long-term administration.
Risk Factors of Elderly Type 2 Diabetes Mellitus Complicated with Osteoporosis and Effects of Vitamin K1 on Bone Mineral Density and Insulin Resistance, American Journal of Life Sciences.
Vol. 7, No. 1,
2019, pp. 12-16.
Takeuchi Y. Diabetes mellitus and osteoporosis. Therapeutic strategy for osteoporosis in patients with diabetes mellitus. Clin Calcium, 2016, 22 (9): 1410-1415.
Williams EA. Folate, colorectal cancer and the involvement of DNA methylation. Proc Nutr Soc, 2017, 71 (4): 592-7.
Melton LJ, Leibson CL, Achenbach SJ, et al. Fracture risk in type 2 diabetes：update of a population-based study. J Bone Miner Res, 2018, 23 (8): 1334.
Watanabe R, Okazaki R. Diabetes mellitus and osteoporosis. Diabetes mellitus and bone and calcium metabolism. Clin Calcium, 2012, 22 (9): 1307-1014.
Xicola RM. Llor X. et al. DNA methylation defects in sporadic and hereditary colorectal cancer [J]. Gastroenterol Hepatol, 2017, 35 (7): 480-7.
Al-Lawati JA, N Barakat M, Al-Zakwani I, et al. Control of risk factors for cardiovascular disease among adults with previously diagnosed type 2 diabetes mellitus: a descriptive study from a middle eastern arab population. Open Cardiovasc Med J, 2018; 6: 133-40.
Abdulameer SA, Sulaiman SA, Hassali MA, et al. Osteoporosis and type 2 diabetes mellitus: what do we know, and what we can do? Patient Prefer Adherence, 2017; 6: 435-48.
Koroglu BK, Kiris F, Ersoy IH, et al. Relation of leptin, adiponectin and insulin resistance to bone mineral density in type 2 diabetic postmenopausal women. Endokrynol Pol, 2017; 62 (5): 429-35.
Hayakawa N, Suzuki A. Diabetes mellitus and osteoporosis. Effect of antidiabetic medicine on osteoporotic fracture. Clin Calcium, 2018, 22 (9): 1383-1390.
Uenishi K. Diabetes mellitus and osteoporosis. Dietary therapy of diabetes related osteoporosis. Clin Calcium, 2012, 22 (9): 1398-1402.
Yamada S, Inaba M. Diabetes mellitus and osteoporosis. Bone metabolic disorder in diabetic nephropathy. Clin Calcium, 2016, 22 (9): 1333-1341.
Knudsen ST, Jeppesen P, Poulsen PL, et al. Plasma concentrations of osteoprotegerin during normo- and hyperglycaemic clamping. Scand J Clin Lab Invest, 2017, 67: 135-142.
Wongdee K, Charoenphandhu N. Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms. World J Diabetes, 2018, 2 (3): 41-48.
Vieru A, Niţă O, Graur LI, et al. Neuropad test in evaluation of diabetic foot. Rev Med Chir Soc Med Nat Iasi, 2018, 116 (1): 90-96.
Yoshida M, Jacques PF, Meigs JB, et al. Effect of vita-min K supplementation on insulin resistance in older men and women. Diabetes Care, 2018, 31 (11): 2092.
Yasuda S, Wada S. Diabetic osteopahty and vitamin K. Clin Calcium, 2016, 16 (8): 1351-1357. Iwamoto J, Yeh JK, Sato Y, et al. Comparative effects of vitamin K and vitamin D supplementation on calcium balance in young rats fed normal or lows calcium diets. Nutr Sci Vitaminol (Tokyo), 2017, 51 (4): 211.
Wada S. Therapeutic approaches for diabetic osteopathy. Clin Calcium, 2016, 16 (8): 1297-1304. Roe DA. Drug and nutrient interactions in the elderly diabetic. Drug Nutr Interact, 2018, 5 (4): 195-203.
Kaneda A. Yagi K. et al. Two groups of DNA methylation markers to classify colorectal cancer into three epigenotypes. Cancer Sci, 2017, 102 (1): 18-24.
Kim JW. Park HM. et al. Polymorphisms in genes involved in folate metabolism and plasma DNA methylation in colorectal cancer patients. Oncol Rep, 2018, 25 (1): 167-72.