Tip 2 diyabet hastalarında dolaşımdaki B-tipi natriüretik peptidin osteoporoz ile ilişkisi

Yıl 2022, Cilt: 3 Sayı: 2, 75 - 80, 28.06.2022

Murat Doğan

https://doi.org/10.47582/jompac.1080105

Cited By: 1

Öz

Amaç: Bu çalışmanın amacı tip 2 diabetes mellitus (T2DM) hastalarında dolaşımdaki B-tipi natriüretik peptid (BNP)’in osteoporoz ile ilişkisini değerlendirmektir.
Gereç ve Yöntem: T2DM’li 95 hasta çalışmaya dahil edildi. Hasta dosya sistemlerinde dolaşımdaki BNP seviyeleri olan ve 15 gün içerisinde kemik mineral yoğunluğu (KMY) bakılmış hastalar çalışmaya dahil edildi. Hastalar KMY skorlarına göre normal, osteopeni ve osteoporoz olarak üç gruba ayrıldı. Dolaşımdaki BNP ile diyabetik osteoporoz ve diğer parametreler arasındaki ilişki incelendi.
Bulgular: Çalışmamıza 75’i kadın, 20’si erkek olmak üzere toplam 95 hasta dahil edildi. Hastaların yaş ortalaması 66,09±5,96 idi. Gruplar arasında cinsiyet, yaş ve vücut kitle indeksi (VKİ) benzer bulundu. DM süresi osteoporoz grubunda anlamlı olarak yüksek saptandı (p<0,005). Laboratuvar paramaretlerinin gruplar arası karşılaştırılmasında glukoz, trigliserid, glikolize hemoglobin (HbA1c), alkalen fosfataz (ALP) ve BNP ortalamaları istatistiksel olarak anlamlı şekilde osteoporoz grubunda daha yüksekti (p<0,05).
Sonuç: Dolaşımdaki BNP, T2DM’li osteoporoz hastaları için bir biyobelirteç olarak kullanılabilir.

Anahtar Kelimeler

Tip 2 diabetes mellitus, osteoporoz, B-tipi natriüretik peptid

Destekleyen Kurum

desteklyen herhangi bir kurum yoktur

Association of circulating B-type natriuretic peptide with osteoporosis in patients with type 2 diabetes

Öz

Objective: The aim of this study was to evaluate the relationship of circulating B-type natriuretic peptide (BNP) with osteoporosis in type 2 diabetes mellitus (T2DM) patients.
Material and Method: 95 patients with T2DM were included in the study. Patients with circulating BNP levels in their patient file systems and whose BMD were measured within 15 days were included in the study. The patients were divided into three groups according to their BMD scores as normal, osteopenia and osteoporosis. The relationship between circulating BNP and diabetic osteoporosis and other parameters was investigated.
Results: A total of 95 patients, 75 female and 20 male, were included in our study. The mean age of the patients was 66.09±5.96 years. Gender, age and BMI were similar between the groups. The duration of DM was found to be significantly higher in the osteoporosis group (p<0.005). In the comparison of laboratory parameters between groups, the averages of glucose, triglyceride, HbA1c, ALP and BNP were statistically significantly higher in the osteoporosis group (p<0.05).
Conclusion: Circulating BNP can be used as a biomarker for osteoporosis patients with T2DM.

Anahtar Kelimeler

Type 2 diabetes mellitus, osteoporosis, B-type natriuretic peptide

Kaynakça

• Organization WH. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and Classification of Diabetes Mellitus 1999.
• American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018; 41: 13-27.
• International Diabetes Federation. IDF Diabetes Atlas 8th edition 2017. [erişim 21 December 2021]. Erişim adresi: https://diabetesatlas.org/upload/resources/previous/files/8/IDF_DA_8e-EN-final.pdf
• Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL. IOF Bone and Diabetes Working Group. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol 2017; 13: 208–19.
• Paschou SA, Anagnostis P, Vryonidou A, Goulis DG. Diabetes and atherosclerosis: old players in a new field, Osteoporosis. Curr Vasc Pharmacol 2018; 16: 524–7.
• Mohsin S, Kaimala S, Sunny JJ, Adeghate E, Brown EM. Type 2 diabetes mellitus increases the risk to hip fracture in postmenopausal osteoporosis by deteriorating the trabecular bone microarchitecture and bone mass. J Diabetes Res 2019; 2019: 3876957.
• Suzuki K, Sugimoto C, Takizawa M, et al. Correlations between bone mineral density and circulating bone metabolic markers in diabetic patients. Diabetes Res Clin Pract 2000; 48: 185–91.
• Li Y, Zhao Z, Wang L, Fu Z, Ji L, Wu X. The prevalence of osteoporosis tested by quantitative computed tomography in patients with different glucose tolerances. J Clin Endocrinol Metab 2020; 105: 201-9.
• McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33: 1787-847.
• Ueland T, Dahl CP, Kjekshus J, et al. Osteoprotegerin predicts progression of chronic heart failure: results from CORONA. Circ Heart Fail 2011; 4: 145–52.
• Shiga T, Hosaka F, Wakaumi M, et al. Amiodarone decreases plasma brain natriuretic peptide level in patients with heart failure and ventricular tachyarrhythmia. Cardiovasc Drugs Ther 2003; 17: 325–33.
• Loncar G, Fulster S, von Haehling S, Popovic V. Metabolism and the heart: an overview of muscle, fat, and bone metabolism in heart failure. Int J Cardiol. 2013; 162: 77–85.
• Wang CH, Tsai JP, Lai YH, Lin, YL, Kuo CH, Hsu BG. Inverse relationship of bone mineral density and serum level of N-terminal pro-B-type natriuretic peptide in peritoneal dialysis patients. Tzu Chi Med J 2016; 28: 68-72.
• Diyabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu 2020: Türkiye Endokrinoloji ve Metabolizma Derneği.
• Valderrábano RJ, Linares MI. Diabetes mellitus and bone health: epidemiology, etiology and implications for fracture risk stratification. Clin Diab Endocrinol 2018; 4: 1.
•  Eller-Vainicher C, Falchetti A, Gennari L, et al. Diagnosis of endocrine DISEASE: evaluation of bone fragility in endocrine disorders. Eur J Endocrinol 2019; 180: 213–32.
• Russo G. T, Giandalia A, Romeo EL, et al. Fracture risk in type 2 diabetes: current perspectives and gender differences. Int J Endocrinol 2016; 2016: 11.
• Pinheiro MM, Ciconelli RM, Martini LA, Ferraz MB. Clinical risk factors for osteoporotic fractures in Brazilian women and men: the Brazilian osteoporosis study (BRAZOS) Osteoporos Int 2009; 20: 399–408.
• Huang N, Zhou J, Wang W, et al. Retinol-binding protein 4 is positively associated with bone mineral density in patients with type 2 diabetes and osteopenia or osteoporosis. Clin Endocrinol 2018; 88: 659–64.
• Issa C, Zantout MS, Azar ST. Osteoporosis in men with diabetes mellitus. J Osteoporos 2011; 2011: 651867.
• Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int 2007; 18: 427-44.
• Young MJ, Boulton AJM, Macleod AF, et al. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993; 36: 150-4.
• Karaaslan Y, Osteoartrit, MD Yayıncılık, Ankara, 2000.
• Doğan AG, Boyacıoğlu MZ, Doğan M. Romatoid artritte nötrofil lenfosit ve platelet lenfosit oranlarının hastalık aktivite indeksine göre değerlendirilmesi. J Health Sci Med 2020; 3: 312-6.
• Huang C, Li S. Association of blood neutrophil lymphocyte ratio in the patients with postmenopausal osteoporosis. Pakistan J Med Sci 2016; 32: 762.
• Chen P, Yan P, Wan Q, et al. Association of circulating B-type natriuretic peptide with osteoporosis in a Chinese type 2 diabetic population. BMC Musculoskeletal Disorders 2021; 22: 1-12.
• Beck-da-Silva L, de Bold A, Fraser M, Williams K, Haddad H. Brain natriuretic peptide predicts successful cardioversion in patients with atrial fibrillation and maintenance of sinus rhythm. Can J Cardiol 2004; 20: 1245-8.
• Lee MC, Lee CJ, Shih MH, Ho GJ, Chen YC, Hsu BG. N-terminal pro-B-type natriuretic peptide is inversely related to bone mineral density in renal transplant recipients. Transplant Proc 2014; 46: 3443–7.
• Kajita M, Ezura Y, Iwasaki H, et al. Association of the -381T/C promoter variation of the brain natriuretic peptide gene with low bone-mineral density and rapid postmenopausal bone loss. J Hum Genet 2003; 48: 77–81.