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  • 1 DRC Ltd. Ady Endre u. 12 H-8231 Balatonfüred Hungary
  • 2 Péterfy Sándor Hospital Department of Cardiology Budapest Hungary
  • 3 City Hospital Osteoporosis Clinic Szigetvár Hungary
  • 4 University of Debrecen 1st Department of Medicine Debrecen Hungary
  • 5 State Hospital of Cardiology Balatonfüred Hungary
  • 6 Pannon University Department of Mathematics and Computational Methods Veszprém Hungary
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Worldwide there is an increasing number of patients with insulin resistance, type 2 diabetes mellitus and osteoporosis. Paradoxically, the diabetes epidemic is driven by the same obesity which protects the bones in obese females. With these core facts in mind the aim of the study was to investigate the connection between early glucose intolerance, insulin resistance, bone density and metabolism. Patients and methods: 20 healthy patients and 51 glucose intolerant women in perimenopause matched for age (49 ± 9 years) were selected for the study. Their metabolic status was determined by OGTT and hyperinsulinemic-euglycemic clamp. For each of these patients, glucose, insulin, leptin, resistin, adiponectin and lipid levels were measured. Body composition and bone mineral density over lumbar spine and the femur neck were measured by DEXA. Results: There was no difference in BMD observed between the two groups. Significant correlation was found between total body glucose utilisation and bone density in the healthy group (lumbar spine r = –0,4921, p < 0.05, femur neck: r = –0.4972, p < 0.05), while this correlation disappeared (lumbar spine: r = –0.022, ns; femur neck: r = –0.314, ns) with deteriorating glucose tolerance. Among adipokines measured, only adiponectin correlated with lumbar spine density in both groups ( r = –0.5081, p < 0.05; –0.2804, p < 0.05), but not with femur density where this connection disappeared in glucose intolerance (r = –0.6742, p < 0.01; –0.1723, ns). Resorption quotient formed by P1NP/β-crosslaps increased significantly in glucose intolerant subjects. This suggests that bone resorption decreases with worsening insulin resistance. Conclusion: Inverse correlation was found between bone density, glucose metabolism and insulin sensitivity in healthy women in perimenopause. Furthermore, this connection disappeared with the deterioration of glucose metabolism and the progression of insulin resistance. Decreasing insulin sensitivity of bones and the “escape” from metabolic control may result in hyperdensity, which is frequently observed in Type 2 diabetics.

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