Abstract
The aim of the study was to investigate whether the biomarkers for bone turnover
could rapidly recover during the period of diabetic ketoacidosis (DKA). Bone
turnover biomarkers, including 25-hydroxyvitamin D3, N-terminal middle molecular
fragment of osteocalcin (NMID), and β-C terminal cross-linking
telopeptide of type 1 collagen were evaluated using in-patient data
(n=627) from Shanghai Pudong Hospital from 2018–2022. The
comparison was performed between type 2 diabetes (T2D only) (n=602) and
DKA (n=25), in which we checked the bone turnover markers at
pre-treatment and recovery. After matching by body mass index (BMI), we found
that except for 25-OH-VitD3, the age difference, indices of glucose metabolism,
and bone turnover were significant between the 2 groups (p<0.05). We
found only a significant restoration of NMID (p<0.001). NMID and
β-CTX, when compared with T2D, showed overt distinction between recovery
and T2D (p<0.05). In addition, the investigations demonstrated a
substantial difference between 25-OH-VitD3 in males and NMID in females,
regardless of age (p<0.05). Multilinear regression analysis revealed
that 2 hours postprandial plasma C-peptide was an independent predictor
of the NMID in both pre-treatment (β=0.58, p=0.003) and
recovery (β=0.447, p=0.025), although sex was
significant in pre-treatment (β=–0.444,
p=0.020). Finally, we found that only age variation affected
DKA’s fasting plasma glucose level (p<0.05). The study revealed
that the bone turnover of DKA is significantly different in pre-treatment and
recovery; however, NMID might recover quickly if the patients received
appropriate treatment. Importantly, pancreatic function plays a critical role in
changing bone turnover biomarkers.
Keywords
diabetic ketoacidosis - bone turnover markers - pancreatic function
