02724nas a2200265 4500008004100000022001400041245012000055210006900175260001200244300001400256490000700270520190700277100002102184700001902205700002402224700002402248700001902272700001802291700003002309700002402339700002202363700001702385700002002402856003602422 2018 eng d a1935-554800aBiochemical Markers of Bone Turnover and Risk of Incident Diabetes in Older Women: The Cardiovascular Health Study.0 aBiochemical Markers of Bone Turnover and Risk of Incident Diabet c2018 09 a1901-19080 v413 a

OBJECTIVE: To investigate the relationship of osteocalcin (OC), a marker of bone formation, and C-terminal cross-linked telopeptide of type I collagen (CTX), a marker of bone resorption, with incident diabetes in older women.

RESEARCH DESIGN AND METHODS: The analysis included 1,455 female participants from the population-based Cardiovascular Health Study (CHS) (mean [SD] age 74.6 [5.0] years). The cross-sectional association of serum total OC and CTX levels with insulin resistance (HOMA-IR) was examined using multiple linear regression. The longitudinal association of both markers with incident diabetes, defined by follow-up glucose measurements, medications, and ICD-9 codes, was examined using multivariable Cox proportional hazards models.

RESULTS: OC and CTX were strongly correlated ( = 0.80). In cross-sectional analyses, significant or near-significant inverse associations with HOMA-IR were observed for continuous levels of OC (β = -0.12 per SD increment; = 0.004) and CTX (β = -0.08 per SD; = 0.051) after full adjustment for demographic, lifestyle, and clinical covariates. During a median follow-up of 11.5 years, 196 cases of incident diabetes occurred. After full adjustment, both biomarkers exhibited inverse associations with incident diabetes (OC: hazard ratio 0.85 per SD [95% CI 0.71-1.02; = 0.075]; CTX: 0.82 per SD [0.69-0.98; = 0.031]), associations that were comparable in magnitude and approached or achieved statistical significance.

CONCLUSIONS: In late postmenopausal women, lower OC and CTX levels were associated with similarly increased risks of insulin resistance at baseline and incident diabetes over long-term follow-up. Further research to delineate the mechanisms linking abnormal bone homeostasis and energy metabolism could uncover new approaches for the prevention of these age-related disorders.

1 aMassera, Daniele1 aBiggs, Mary, L1 aWalker, Marcella, D1 aMukamal, Kenneth, J1 aIx, Joachim, H1 aDjoussé, Luc1 aValderrábano, Rodrigo, J1 aSiscovick, David, S1 aTracy, Russell, P1 aXue, XiaoNan1 aKizer, Jorge, R uhttps://chs-nhlbi.org/node/7804