ASSESSMENT OF BONE METABOLISM MARKERS IN DIABETIC PATIENTS: INFLUENCE OF OSTEOPOROSIS, AGE, AND GENDER

Background:Diabetes mellitus is linked to changes in bone metabolism, which may result in osteoporosis and a heightened risk of fractures. There is still little research on the incidence and biochemical characteristics of these alterations in diabetic people in Iraq.
Objectives:The aim of this study is to assess serum bone metabolism indicators in diabetic patients, both with and without osteoporosis, and to compare these markers with those of healthy controls, while accounting for age and gender variations.
Materials and Methods:This study involved 219 individuals aged 40–80 years, including 149 diabetic patients (with and without osteoporosis) and 70 healthy controls, recruited from hospitals and clinics in Kirkuk, Iraq. Participants were grouped as follows: G1 – diabetics without osteoporosis, G2 – diabetics with osteoporosis, and G3 – healthy controls. Blood samples were collected after overnight fasting, and serum was separated for biochemical analysis. Bone metabolism markers-type I collagen, osteocalcin, and TRACP-5b—were quantified using ELISA and ECLIA techniques according to standard protocols.
Results:Results revealed statistically significant elevations (P < 0.05) in serum collagen type I, osteocalcin, and TRACP among diabetic patients compared to controls, indicating altered bone turnover. Additionally, these markers were significantly higher in diabetic patients with osteoporosis, especially TRACP and collagen type I, reflecting increased
bone resorption. Age-related analysis showed significant increases in TRACP in older osteoporotic patients (P < 0.0001), while osteocalcin showed no significant age-related variation. Gender analysis revealed higher collagen type I in nonosteoporotic males (P = 0.005) and significantly elevated TRACP in osteoporotic females (P < 0.0001), suggesting gender- and age-related modulation of bone metabolism in diabetes.
Conclusion: Diabetic patients exhibit altered bone turnover, with more pronounced changes in those with osteoporosis.
These alterations are modulated by age and gender, suggesting the need for targeted bone health assessment in diabetic populations.