Acute Hyperinsulinemia Alters Bone Turnover in Women and Men With Type 1 Diabetes

ABSTRACT: ABSTRACT Type 1 diabetes (T1D) increases fracture risk across the lifespan. The low bone turnover associated with T1D is thought to be related to glycemic control, but it is unclear whether peripheral hyperinsulinemia due to dependence on exogenous insulin has an independent effect on suppressing bone turnover. The purpose of this study was to test the bone turnover marker (BTM) response to acute hyperinsulinemia. Fifty?eight adults aged 18 to 65?years with T1D over 2?years were enrolled at seven T1D Exchange Clinic Network sites. Participants had T1D diagnosis between age 6?months to 45?years. Participants were stratified based on their residual endogenous insulin secretion measured as peak C?peptide response to a mixed meal tolerance test. BTMs (CTX, P1NP, sclerostin [SCL], osteonectin [ON], alkaline phosphatase [ALP], osteocalcin [OCN], osteoprotegerin [OPG], osteopontin [OPN], and IGF?1) were assessed before and at the end of a 2?hour hyperinsulinemic?euglycemic clamp (HEC). Baseline ON (r = ?0.30, p = .022) and OCN (r = ?0.41, p = .002) were negatively correlated with age at T1D diagnosis, but baseline BTMs were not associated with HbA1c. During the HEC, P1NP decreased significantly (?14.5?±?44.3%; p = .020) from baseline. OCN, ON, and IGF?1 all significantly increased (16.0?±?13.1%, 29.7?±?31.7%, 34.1?±?71.2%, respectively; all p?

SUBMITTER: Sherk V 

PROVIDER: S-EPMC7507374 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature