Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2023; 14(5): 594-605
Published online May 15, 2023. doi: 10.4239/wjd.v14.i5.594
Association of bone turnover biomarkers with severe intracranial and extracranial artery stenosis in type 2 diabetes mellitus patients
Si-Cong Si, Wei Yang, Hong-Yu Luo, Yi-Xin Ma, Huan Zhao, Jia Liu
Si-Cong Si, Wei Yang, Hong-Yu Luo, Yi-Xin Ma, Huan Zhao, Jia Liu, General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
Author contributions: Si SC and Yang W contributed to the study conception and design; Liu J, Luo HY, Ma YX and Zhao H recruited patients and supervised the study process; Si SC analyzed the data and wrote the manuscript; and all authors read and approved the final article.
Supported by Beijing Municipal Hospital Management Center “Cultivation Plan”, No. PX2022032.
Institutional review board statement: This study was approved by the Ethics Committees of Xuanwu Hospital of Capital Medical University.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: The data from this article will be provided by the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Yang, MD, Chief Doctor, General Geriatric Department, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. yangw_79@163.com
Received: February 28, 2023
Peer-review started: February 28, 2023
First decision: March 14, 2023
Revised: March 20, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 15, 2023
ARTICLE HIGHLIGHTS
Research background

Intracranial and extracranial artery stenosis is associated with cerebral infarction. Vascular calcification and atherosclerosis are the main causes of stenosis and major risk factors for cardiovascular and cerebrovascular events in patients with type 2 diabetes mellitus (T2DM).

Research motivation

Our study found that bone turnover biomarkers (BTMs) are associated with the risk of arterial stenosis, probably due to the relationship between BTMs and glucose and lipid metabolism disorders. Detection of BTMs in patients with T2DM may help reduce the occurrence of cardiovascular disease.

Research objectives

This study aimed to investigate the association of circulating BTM levels with severe intracranial and extracranial artery stenosis in patients with T2DM.

Research methods

After overnight fasting for 12 h, peripheral venous blood samples were collected early the next morning for all patients. Fasting plasma glucose, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum creatinine, blood urea nitrogen, and uric acid levels were measured by an automatic analyzer. The glycated hemoglobin (HbA1c) level was measured by high-pressure liquid chromatography. Insulin, C-peptide, osteocalcin (OC), C-terminal cross-linked telopeptide of type I collagen (CTX), and procollagen type I N-peptide (PINP) levels were determined using an electrical chemiluminescent immunoassay.

Research results

Among the 257 T2DM patients included in this study, 136 were female and 121 were male. The mean age of all participants was 66 ± 11 years. The average duration of T2DM among all patients was 12.0 ± 13.0 years. Overall, 87.2% had no stenosis, and 12.8% had some form of stenosis. Compared with the no severe intracranial and extracranial artery stenosis group, the artery stenosis group had a higher percentage of patients with a history of stroke and higher levels of HbA1c, OC, CTX, and PINP.

Research conclusions

Elevated BTM levels correlated with an increased risk of artery stenosis in patients with T2DM as well as with several indicators of metabolic syndrome. Accordingly, BTM levels may serve as circulating endocrine markers that reflect the regulation of glucose and lipid metabolism, thereby reflecting the risk of vascular disease in patients with T2DM.

Research perspectives

BTMs may also represent potential therapeutic targets for atherosclerosis, and additional research is warranted to explore the underlying mechanism linking BTMs and atherosclerosis.