Abstract:
It is unclear if AGEs are involved in the bone fragility of type 1 diabetes (T1D). We evaluated whether skin AGEs by skin autofluorescence and serum AGEs (pentosidine, carboxymethyl-lysine [CML]) are independently associated with BMD by DXA (lumbar spine, hip, distal radius), trabecular bone score (TBS), serum bone turnover markers (BTMs: CTX; P1NP; osteocalcin), and sclerostin in participants with and without T1D. Linear regression models were used, with interaction terms to test effect modification by T1D status. In participants with T1D, correlations between skin and serum AGEs as well as between AGEs and 3-year HbA1C were evaluated using Spearman\'s correlations. Data are mean ± SD or median (interquartile range). We included individuals who participated in a cross-sectional study and had BMD and TBS assessment (106 T1D/65 controls, 53.2% women, age 43 ± 15 yr, BMI 26.6 ± 5.5 kg/m2). Participants with T1D had diabetes for 27.6 ± 12.3 yr, a mean 3-yr HbA1C of 7.5 ± 0.9% and skin AGEs of 2.15 ± 0.54 arbitrary units. A subgroup of 65 T1D/57 controls had BTMs and sclerostin measurements, and those with T1D also had serum pentosidine (16.8[8.2-32.0] ng/mL) and CML [48.0 ± 16.8] ng/mL) measured. Femoral neck BMD, TBS, and BTMs were lower, while sclerostin levels were similar in participants with T1D vs controls. T1D status did not modify the associations between AGEs and bone outcomes. Skin AGEs were significantly associated with total hip and femoral neck BMD, TBS, BTMs, and sclerostin before, but not after, adjustment for confounders. Serum AGEs were not associated with any bone outcome. There were no significant correlations between skin and serum AGEs or between AGEs and 3-yr HbA1C. In conclusion, skin and serum AGEs are not independently associated with BMD, TBS, BTMs, and sclerostin in participants with relatively well-controlled T1D and participants without diabetes.
摘要:
目前尚不清楚AGEs是否与1型糖尿病(T1D)的骨脆性有关。我们通过皮肤自发荧光和血清AGEs(戊糖苷,羧甲基赖氨酸[CML])通过DXA独立地与BMD相关(腰椎,臀部,桡骨远端),骨小梁评分(TBS),血清骨转换标志物(BTMs:CTX;P1NP;骨钙蛋白),和硬化蛋白在有和没有T1D的参与者中。使用线性回归模型,用相互作用项测试T1D状态的效果修饰。在T1D的参与者中,使用Spearman相关性评估皮肤和血清AGEs之间以及AGEs和3年HbA1C之间的相关性。数据为平均值±SD或中值(四分位数间距)。我们纳入了参与横断面研究并进行BMD和TBS评估的个体(106个T1D/65对照,53.2%的女性,年龄43±15岁,BMI26.6±5.5kg/m2)。T1D患者患有糖尿病27.6±12.3年,平均3年HbA1C为7.5±0.9%,皮肤AGEs为2.15±0.54任意单位。65个T1D/57对照的亚组有BTMs和硬化蛋白测量,T1D患者的血清戊糖苷(16.8[8.2-32.0]ng/mL)和CML[48.0±16.8]ng/mL)。股骨颈BMD,TBS,BTMs较低,而T1D参与者与对照组的硬化蛋白水平相似。T1D状态没有改变AGEs与骨结局之间的关联。皮肤AGEs与全髋关节和股骨颈BMD显著相关,TBS,BTMs,和硬化蛋白之前,但不是之后,对混杂因素的调整。血清AGEs与任何骨预后无关。皮肤和血清AGEs之间或AGEs与3年HbA1C之间没有显着相关性。总之,皮肤和血清AGEs与BMD无关,TBS,BTMs,和硬化蛋白在T1D控制相对良好的参与者和无糖尿病的参与者中。