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Urinary Pentosidine levels negatively associates with trabecular bone scores in patients with type 2 diabetes mellitus

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Abstract

Summary

Pentosidine levels were higher in diabetic patients with vertebral fractures. Trabecular bone scores were negatively associated with pentosidine levels in diabetic patients only. Our results provide further evidence that AGEs are associated with the pathogenesis of bone fragility in patients with T2DM.

Introduction

Type 2 diabetes mellitus (T2DM) is associated with fracture risk. Pentosidine, an advanced glycation end product (AGE), is associated with prevalent vertebral fractures (VFs) in patients with T2DM. Trabecular bone score (TBS) has been proposed as an index of bone microarchitecture associated with bone quality. This study evaluated the associations of urine pentosidine and TBS in T2DM and non-T2DM groups.

Methods

A total of 112 T2DM patients and 62 non-T2DM subjects were enrolled. TBS was calculated using TBS insight® software (version 2.1). Pentosidine levels were measured using high-performance liquid chromatography method. We compared the BMD, TBS, and pentosidine levels between those with and without VFs with or without adjustment for age and sex. The association with TBS, lumbar spine BMD, and pentosidine levels were also evaluated in both T2DM and non-T2DM groups.

Results

Pentosidine levels were significantly higher in T2DM patients with VFs. TBSs were significantly lower in patients with T2DM and VFs. In non-diabetic patients, there were no significant differences in TBS and pentosidine levels for those with and without VFs after adjustment for age and sex. Pentosidine levels were negatively associated with TBS only in patients with T2DM. In multivariate stepwise regression analysis, pentosidine levels were significantly associated with TBS in patients with T2DM.

Conclusions

TBS and pentosidine could be used as a method to assess bone quality to identify T2DM patients at risk of VFs. Our results also provide further evidence that AGEs are associated with the pathogenesis of bone fragility in patients with T2DM.

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Acknowledgements

This research was partly supported by the Korea Health Technology R&D Project (HI16C0992), through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health and Welfare, Republic of Korea (So Hee Kim). The authors are grateful to the technologist, Byung Joo Lee, for his assistance with the analyses of trabecular bone score. The authors are also grateful to professor Yunhwan Lee for his advice on the statistical analyses.

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Correspondence to Y. -S. Chung.

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Receiver operating characteristic curve analysis of pentosidine with VFs. (GIF 14 kb)

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Choi, Y.J., Ock, S.Y., Jin, Y. et al. Urinary Pentosidine levels negatively associates with trabecular bone scores in patients with type 2 diabetes mellitus. Osteoporos Int 29, 907–915 (2018). https://doi.org/10.1007/s00198-017-4359-7

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  • DOI: https://doi.org/10.1007/s00198-017-4359-7

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