c-peptide and Osteoporosis

C-peptide secretion is deficient or absent in type 1 diabetes mellitus. It is well accepted that insulin replacement therapy cannot prevent the development of long-term diabetes-related complications, which can often be disabling or even life-threatening. Several cross-sectional investigations have suggested that residual C-peptide production in patients with type 1 diabetes mellitus would help prevent a number of complications. In animal models of diabetes and in patients with type 1 diabetes mellitus, C-peptide replacement improves renal function, skin and skeletal muscle blood flow, nerve conduction, glucose utilization, and other diabetes-related complications. Recent investigations suggest a new beneficial effect of C-peptide, which to date has never been studied. It is known that osteoporosis is the most prevalent short-term complication in type 1 diabetes mellitus. This review will highlight new insights into the pathophysiology and future therapeutic modalities for osteoporosis in individuals with diabetes.. This review provides a concise summary of old and new insights into the role of C-peptide in diabetes-related complications.. Taken together these studies encourage further investigations to elucidate the role of C-peptide in preventing bone loss in type 1 diabetes mellitus and in those individuals with C-peptide deficiency and osteoporosis.

Topics: Bone and Bones; C-Peptide; Diabetes Complications; Diabetes Mellitus; Fractures, Bone; Humans; Osteoporosis

This study revealed that there was no significant linear relationship between fasting C-peptide (FCP) level and bone mineral density (BMD) or fracture risk in type 2 diabetes mellitus (T2DM) patients. However, in the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with whole body (WB), lumbar spine (LS), and femoral neck (FN) BMD and negatively correlated with fracture risk.. To explore the relationship between C-peptide and BMD and fracture risk in T2DM patients.. 530 T2DM patients were enrolled and divided into three groups by FCP tertiles, and the clinical data were collected. BMD was measured by dual-energy X-ray absorptiometry (DXA). The 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was evaluated by adjusted fracture risk assessment tool (FRAX).. In the FCP ≤ 1.14 ng/ml group, FCP level was positively correlated with WB, LS, and FN BMD, while FCP was negatively correlated with fracture risk and osteoporotic fracture history. However, FCP was not correlated with BMD and fracture risk and osteoporotic fracture history in the 1.14 < FCP ≤ 1.73 ng/ml and FCP > 1.73 ng/ml groups. The study has shown that FCP was an independent factor influencing BMD and fracture risk in the FCP ≤ 1.14 ng/ml group.. There is no significant linear relationship between FCP level and BMD or fracture risk in T2DM patients. In the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with WB, LS, and FN BMD and negatively correlated with fracture risk, and FCP is an independent influencing factor of BMD and fracture risk. The findings suggest that FCP may predict the risk of osteoporosis or fracture in some T2DM patients, which has a certain clinical value.

Topics: Absorptiometry, Photon; Bone Density; C-Peptide; Diabetes Mellitus, Type 2; Humans; Osteoporosis; Osteoporotic Fractures; Risk Assessment; Risk Factors

Although serum C-peptide was previously considered biologically inactive, a growing number of recent studies have shown that it is an active peptide with important physiologic functions. The present study aimed to investigate the association of serum C-peptide level with bone mineral density (BMD) in residents of the United States.. The study included 6,625 participants aged 12-85 years. Total and regional BMD were measured using dual-energy X-ray absorptiometry. Stratified multiple linear regression analysis was performed to determine the association of the serum C-peptide level with BMD. Three regression models were produced for each stratum. All models were adjusted for ethnicity, height, weight, education level, physical activity, smoking status, alcohol use, triglycerides and creatinine level, and models 2 and 3 were further adjusted for the fasting plasma glucose (FPG) and alkaline phosphatase (ALP) levels, respectively.. Sex-specific results showed a significant association between the serum C-peptide level and total BMD in both sexes. Stratified analyses based on age and body mass index showed that serum C-peptide levels were significantly negatively associated with most regional BMD, and most of these associations remained significant after stratification based on the serum insulin level.. The serum C-peptide level was significantly negatively associated with the total and most regional BMD. These findings suggest that serum C-peptide may have biological activity associated with bone metabolism and therefore serum C-peptide control is advisable in order to reduce the risk of low bone mineral density.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Density; C-Peptide; Child; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Nutrition Surveys; Osteoporosis; United States; Young Adult

Spinal cord injury is associated with the development of a rapid and severe osteoporosis which might reflect uncoupling between bone formation and resorption. A prospective study was made in 6 spinal cord injury patients followed up to 2-3 months after onset with various markers of a) bone formation: osteocalcin and C-terminal peptide of type I procollagen, b) bone resorption: pyridinolines and C-terminal telopeptide of type I collagen, c) connective tissue metabolism: amino-terminal propeptide of type III collagen (PIIINP). Preliminary results show that early after onset, bone formation was depressed as compared to dramatically increased bone resorption. Low bone formation rate lasted two weeks before it began to raise, while bone resorption showed a continuous tendency to increase. The dramatic increase in PIIINP levels might represent some attempt of bone to repair. This paper describes the evolution of various biochemical markers of bone and connective tissue metabolism after onset of paralysis and critically reviews the use of those markers in patients with spinal cord injury.

Topics: Adult; Biomarkers; Bone and Bones; Bone Development; Bone Remodeling; Bone Resorption; C-Peptide; Humans; Male; Osteocalcin; Osteoporosis; Peptide Fragments; Procollagen; Prospective Studies; Spinal Cord Injuries

Because of the previous controversial findings in diabetic patients with older methodologies, we assessed bone mineral density (BMD) in 78 patients (38 males and 40 females) with non-insulin-dependent diabetes mellitus using dual energy x-ray absorptiometry (DEXA). BMD was measured in lumbar vertebrae (L2-4). The BMD of each patient was calculated as the percentage of the mean value (%BMD) obtained from a healthy control group matched for sex and age. The %BMD of the patients with diabetes was about 100% for females and 96% for males, as compared with BMD of normal controls. The %BMD of the patients with diabetes was significantly correlated with body mass index and urinary C peptide level, and inversely correlated with age and duration of diabetes within 20 years. No relationships were found between %BMD and serum calcium, phosphorus, or glycosylated hemoglobin A1C levels. These observations suggest that metabolic abnormalities associated with diabetes mellitus alter the BMD, and that such factors as duration of the disease and deficit in insulin secretion are risk factors for decreased BMD.

Topics: Absorptiometry, Photon; Adult; Aged; Aged, 80 and over; Bone Density; C-Peptide; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Female; Humans; Lumbar Vertebrae; Male; Middle Aged; Osteoporosis

The effect of long term (two months) administration of synthetic salmon calcitonin (100 MRC Units per day) on plasma glucose, insulin, C-peptide, glucagon and growth hormone responses to iv glucose and arginine were investigated in patients with either Paget's disease of bone (n = 6) or significant osteoporosis (n = 9). Glucose tolerance did not deteriorate after treatment, despite a reduction in the early insulin response to glucose, resetting of the C-peptide response at a lower level and a reduction in glucose-mediated glucagon suppression. The rise in plasma glucose triggered by arginine was reduced after treatment despite similar hormonal environment. This seems to suggest a positive influence of calcitonin on glucose disposal. The diabetogenic action of acute calcitonin administration is not observed after prolonged administration of the hormone. However, the possibility that calcitonin may produce a diabetic state in subjects with decreased insulin reserve cannot be totally exclused.

Topics: Aged; Arginine; Blood Glucose; C-Peptide; Calcitonin; Female; Glucagon; Glucose; Glucose Tolerance Test; Growth Hormone; Humans; Insulin; Male; Middle Aged; Osteitis Deformans; Osteoporosis

The regulatory functions of vitamins are described with particular reference to their importance in the metabolic processes of ageing. Although clear hypovitaminosis is uncommon, slight vitamin deficiencies are often encountered in the clinical practice. They cause a speed up of the organism deterioration. The nutritional requirement and the effect of vitamin A, B1, B6, B12, are rapidly reviewed. More attention is paid to the data about vitamin C, D and E. Vitamin C deficiency in elderly, especially in the hospitalized ones; whereas a high content of ascorbic acid in necessary in order to extend the life length and to achieve a good self-sufficiency. Also the deficiency of vitamin D and of its metabolites is frequent in the aged due to both a lower uptake and a scarce exposure to the sunlight. Low levels of vitamin D cause a worsening of bone tissue and consequent demineralization (osteomalacia and osteoporosis). Some aspects of ageing can be prevented by the supply of vitamin E, particularly the impaired bone trophism. The anti-oxidant power of tocopherol could also interfere some pathogenetic processes of ageing.

Topics: Adolescent; Adult; Aged; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; C-Peptide; Calcifediol; Child; Child, Preschool; Humans; Hydroxycholecalciferols; Insulin; Middle Aged; Osteomalacia; Osteoporosis; Prediabetic State; Vitamin D Deficiency; Vitamin E