The Relationships Between Glycated Hemoglobin and Bone Turnover Markers in Patients with Type 2 Diabetes but No Diabetic Nephropathy

Hang Zhao,1 Miaomiao Zhang,2 Yunfeng Zhen,1 Yong Tang1 1Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Graduate School of Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of ChinaCorrespondence: Yong Tang, Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email forever830202@163.comPurpose: To investigate the relationships between glycated hemoglobin (HbA1c) level and bone turnover markers (BTMs) in patients with type 2 diabetes mellitus (T2DM) but no diabetic nephropathy.Patients and Methods: Patients with T2DM were recruited at Hebei General Hospital in China. The participants were allocated to three groups: an HbA1c < 7% group, an HbA1c 7%– 9% group, and an HbA1c ≥ 9% group. Their general characteristics, biochemical indices, and BTM concentrations were recorded.Results: The ages of the HbA1c < 7% group and the HbA1c 7%– 9% group were significantly higher than that of the HbA1c ≥ 9% group (P< 0.05). The prevalence of a history of hypertension in the HbA1c 7%– 9% group was significantly higher than that in the HbA1c ≥ 9% group. The circulating low-density lipoprotein-cholesterol concentration in the HbA1c ≥ 9% group and the apolipoprotein B concentration in the HbA1c 7%– 9% group were significantly higher than those in the HbA1c < 7% group (P< 0.05). Compared with that in the HbA1c < 7% group, the circulating 25-hydroxyvitamin D (25OHD) concentration was significantly lower in the HbA1c ≥ 9% group (P< 0.05). Additionally, the circulating 25OHD and osteocalcin (OC) concentrations negatively correlated with HbA1c (P< 0.05).Conclusion: An increase in HbA1c is associated with gradual decreases in the circulating concentrations of 25OHD and OC.Keywords: type 2 diabetes, glycated hemoglobin, diabetic nephropathy, bone turnover markers