<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2020.149</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-836</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Original articles</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group></article-categories><title-group><article-title>Bone remodeling in patients with type I and type II diabetes mellitus in pre- and postmenopausal periods</article-title><trans-title-group xml:lang="ru"><trans-title>Костное ремоделирование у пациенток с сахарным диабетом I и II типа в пре- и постменопаузальном периодах</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7131-3878</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафарова</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Safarova</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сафарова Саин Саттар - кандидат медицинских наук, доцент кафедры внутренних болезней II.AZ 1078 Баку, ул. Братьев Мардановых, д. 100.</p></bio><bio xml:lang="en"><p>Sain S. Safarova - MD, PhD, Associate Professor, Department of Internal Medicine II, Azerbaijan Medical University.100 Bratyev Mardanovykh Str., Baku AZ 1078.</p></bio><email xlink:type="simple">dr.safarovas@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6331-8233</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафарова</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Safarova</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сафарова Саин Саттар - кандидат медицинских наук, доцент кафедры внутренних болезней II.AZ 1078 Баку, ул. Братьев Мардановых, д. 100.</p></bio><bio xml:lang="en"><p>Saadet S. Safarova - MD, PhD, Associate Professor, Department of Obstetrics and Gynecology I, Azerbaijan Medical University.100 Bratyev Mardanovykh Str., Baku AZ 1078.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Азербайджанский медицинский университет</institution><country>Азербайджан</country></aff><aff xml:lang="en"><institution>Azerbaijan Medical University</institution><country>Azerbaijan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>23</day><month>11</month><year>2020</year></pub-date><volume>14</volume><issue>5</issue><fpage>611</fpage><lpage>618</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Safarova S.S., Safarova S.S., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Сафарова С.С., Сафарова С.С.</copyright-holder><copyright-holder xml:lang="en">Safarova S.S., Safarova S.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/836">https://www.gynecology.su/jour/article/view/836</self-uri><abstract><sec><title>Aim</title><p>Aim: to perform structural and functional analysis of the activity of reparative osteogenesis processes at pre- and postmenopausal women with diabetes mellitus (DM).Materials and Methods. There were enrolled 142 pre- and postmenopausal patients with type I and type II diabetes mellitus type (DM-1 and DM-2) as well as 43 females in control group. Subjects taking medicines acting on bone metabolism comorbid with chronic diseases were excluded from the study. All patients underwent Dual-energy X-ray Absorptiometry (DXA) to assess bone mineral density (BMD, T-score). Serum markers of bone remodeling (alkaline phosphatase, ALP; procollagen type I N propeptide, PINP; beta-Cross laps, b-CTx), metabolic and hormone parameters (glycated hemoglobin, parathyroid hormone, calcitonin, vitamin D, electrolytes) were also measured.Results. A positive correlation was found between the duration of DM-1 and DM-2 and b-CTx level (DM-1: г = 0.349, р = 0.08; DM-2: г = 0.214, р = 0.04). A negative correlation was found between the lumbar spine T-score and the duration of diabetes (DM-1: r = -0.568, p = 0.001; DM-2: r = -0.267, p = 0.04). A statistically significant correlation was found between the lumbar spine T-score and b-CTx levels (DM-1: r = -0.452, p = 0.002; DM-2: r = -0.357, p = 0.09).Conclusion. The results of current study suggest that reparative osteogenesis in patients with post-menopausal DM-1 vs. DM-2 and the control group was moderately increased. In patients with DM-2, a less pronounced change in BMD was determined in parallel with inconsistent bone remodeling processes, which casts doubt on the ability of DXA to predict fractures in these patients. Such changes contribute to decreased bone quality, which distinguishes diabetic osteopathy from traditional menopausal osteoporosis manifested mainly by low BMD.</p></sec><sec><title> </title><p> </p></sec></abstract><trans-abstract xml:lang="ru"/><kwd-group xml:lang="ru"><kwd>сахарный диабет</kwd><kwd>постменопауза</kwd><kwd>костный метаболизм</kwd></kwd-group><kwd-group xml:lang="en"><kwd>diabetes mellitus</kwd><kwd>postmenopause</kwd><kwd>bone turnover</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Pramojanee S.N., Phimphilai M., Chattipakorn N. Chattipakorn S.C. Possible roles of insulin signaling in osteoblasts. Endocrine Res. 2014;39(4):144-51. https://doi.org/10.3109/07435800.2013.879168.</mixed-citation><mixed-citation xml:lang="en">Pramojanee S.N., Phimphilai M., Chattipakorn N., Chattipakorn S.C. Possible roles of insulin signaling in osteoblasts. Endocrine Res. 2014;39(4):144-51. https://doi.org/10.3109/07435800.2013.879168.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Vestergaard P., Rejnmark L., Mosekilde L. Diabetes and its complications and their relationship with risk of fractures in type 1 and 2 diabetes. Calcif Tissue Int. 2009;84(1):45-55. https://doi.org/10.1007/s00223-008-9195-5.</mixed-citation><mixed-citation xml:lang="en">Vestergaard P., Rejnmark L., Mosekilde L. Diabetes and its complications and their relationship with risk of fractures in type 1 and 2 diabetes. Calcif Tissue Int. 2009;84(1):45-55. https://doi.org/10.1007/s00223-008-9195-5.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">IDF Diabetes Atlas. 9th Edition. International Diabetes Federation, 2019. 176 р. Available at: https://www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf. [Accessed: 23.04.2020].</mixed-citation><mixed-citation xml:lang="en">IDF Diabetes Atlas. 9th Edition. International Diabetes Federation, 2019. 176 р. Available at: https://www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf. [Accessed: 23.04.2020].</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Farr J.N., Khosla S. Determinants of bone strength and quality in diabetes mellitus in humans. Bone. 2016;82:28-34. https://doi.org/10.1016/j.bone.2015.07.027.</mixed-citation><mixed-citation xml:lang="en">Farr J.N., Khosla S. Determinants of bone strength and quality in diabetes mellitus in humans. Bone. 2016;82:28-34. https://doi.org/10.1016/j.bone.2015.07.027.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Лесняк О.М., Хосева Е.Н. Современные подходы к диагностике и назначению лечения при постменопаузальном остеопорозе. Эффективная фармакотерапия. 2013;(38):6-13.</mixed-citation><mixed-citation xml:lang="en">Lesnyak O.M., Khoseva E.N. Current approaches to postmenopausal osteoporosis diagnosis and treatment. [Sovremennye podhody k diagnostike i naznacheniyu lecheniya pri postmenopauzal'nom osteoporoze]. Effektivnaya farmakoterapiya. 2013;(38):6-13. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Дедов И.И., Мельниченко Г.А., Белая Ж.Е., Рожинская Л.Я. Остеопороз - от редкого симптома эндокринных болезней до безмолвной эпидемии XX-XXI века. Проблемы эндокринологии. 2011;57(1):35-45.</mixed-citation><mixed-citation xml:lang="en">Dedov I.I., Mel'nichenko G.A., Belaia Zh.E., Rozhinskaya L.Ya. Osteoporosis: from a rare symptom of endocrine diseases to the tacit epidemic of XX-XXI centuries. [Osteoporoz - ot redkogo simptoma endokrinnyh boleznej do bezmolvnoj epidemii XX-XXI veka]. Problemy endokrinologii. 2011;57(1):35-45. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Al-Hariri M. Sweet bones: the pathogenesis of bone alteration in diabetes. J Diabetes Res. 2016;2016:6969040. https://doi.org/10.1155/2016/6969040.</mixed-citation><mixed-citation xml:lang="en">Al-Hariri M. Sweet bones: the pathogenesis of bone alteration in diabetes. J Diabetes Res. 2016;2016:6969040. https://doi.org/10.1155/2016/6969040.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Медицина климактерия. Под ред. В.П. Сметник. М.: Литтерра, 2009. 847 с.</mixed-citation><mixed-citation xml:lang="en">Menopause medicine. Ed. V.P. Smetnik. [Medicina klimakteriya. Pod red. V.P. Smetnik]. Moskva: Litterra, 2009. 847 s. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Теппеева Т.Х. Клиническое течение климактерия у женщин Кыргызстана. Universum: медицина и фармакология. 2016;(7):1.</mixed-citation><mixed-citation xml:lang="en">Teppeeva T.Kh. Clinical course of the climacteric syndrome of women of Kyrgyzstan. [Klinicheskoe techenie klimakteriya u zhenshchin Kyrgyzstana]. Universum: medicina i farmakologiya. 2016;(7):1. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Клинические рекомендации. Остеопороз. Диагностика, профилактика и лечение. Под ред. проф. О.М. Лесняк, проф. Л.И. Беневоленской. М.: ГЕОТАР-Медиа, 2010. 137 с. Режим доступа: https://endoinfo.ru/guidelines/rus_osteoporos2009.pdf. [Дата доступа: 23.04.2020].</mixed-citation><mixed-citation xml:lang="en">Clinical guidelines. Osteoporosis. Diagnosis, prevention and therapy. Eds. Prof. O.M. Lesnyak, Prof. L.I. Benevolenskaya. [Klinicheskie rekomendacii. Osteoporoz. Diagnostika, profilaktika i lechenie. Pod red. prof. O.M. Lesnyak, prof. L.I. Benevolenskoj]. Moskva: GEOTAR-Media, 2010. 137 s. (In Russ.). Available at: https://endoinfo.ru/guidelines/rus_osteoporos2009.pdf. [Accessed: 23.04.2020].</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Беневоленская Л.И., Торопцова Н.В. Остеопороз: современные возможности диагностики и лечения. РМЖ. 2010;18(6):389-92.</mixed-citation><mixed-citation xml:lang="en">Benevolenskaya L.I., Toroptsova N.V. Osteoporosis: current diagnostic and treatment options. [Osteoporoz: sovremennye vozmozhnosti diagnostiki i lecheniya]. RMZh. 2010;18(6):389-92. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Assessment of fracture risk and its application to screening for postmenopausal women. Geneva, Switzerland: World Health Organization, 1994. Available at: https://apps.who.int/iris/handle/10665/39142. [Accessed: 23.04.2020].</mixed-citation><mixed-citation xml:lang="en">Assessment of fracture risk and its application to screening for postmenopausal women. Geneva, Switzerland: World Health Organization, 1994. Available at: https://apps.who.int/iris/handle/10665/39142. [Accessed: 23.04.2020].</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Побел Е.А., Бенгус Л.М., Дедух Н.В. Маркеры костного метаболизма при сращении переломов длинных костей. Остеопороз и остеопатии. 2012;15(2):25-32.</mixed-citation><mixed-citation xml:lang="en">Pobel E.A., Bengus L.M., Dedukh N.V. Markers of bone metabolism in long bone's adhesion. [Markery kostnogo metabolizma pri srashchenii perelomov dlinnyh kostej]. Osteoporoz i osteopatii. 2012;15(2):25-32. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Лесняк О.М. Международные научные проекты в области остеопороза: общие усилия, одна цель. Российский семейный врач. 2016;20(2):43-6.</mixed-citation><mixed-citation xml:lang="en">Lesnyak O.M. International research projects in the osteoporosis: common efforts, one goal. [Mezhdunarodnye nauchnye proekty v oblasti osteoporoza: obshchie usiliya, odna cel']. Rossijskij semejnyj vrach. 2016;20(2):43-6. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Safarova S.S. Alterations of bone metabolism in patients with diabetes mellitus. Int J Endocrinol. 2019;2019:5984681. https://doi.org/10.1155/2019/5984681.</mixed-citation><mixed-citation xml:lang="en">Safarova S.S. Alterations of bone metabolism in patients with diabetes mellitus. Int J Endocrinol. 2019;2019:5984681. https://doi.org/10.1155/2019/5984681.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Starup-Linde J., Vestergaard P. Biochemical bone turnover markers in diabetes mellitus - a systematic review. Bone. 2016;82:69-78. https://doi.org/10.1016/j.bone.2015.02.019.</mixed-citation><mixed-citation xml:lang="en">Starup-Linde J., Vestergaard P. Biochemical bone turnover markers in diabetes mellitus - a systematic review. Bone. 2016;82:69-78. https://doi.org/10.1016/j.bone.2015.02.019.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Cunha J.S., Ferreira V.M., Maquigussa E. et al. Effects of high glucose and high insulin concentrations on osteoblast function in vitro. Cell Tissue Res. 2014;358(1):249-56. https://doi.org/10.1007/s00441-014-1913-x.</mixed-citation><mixed-citation xml:lang="en">Cunha J.S., Ferreira V.M., Maquigussa E. et al. Effects of high glucose and high insulin concentrations on osteoblast function in vitro. Cell Tissue Res. 2014;358(1):249-56. https://doi.org/10.1007/s00441-014-1913-x.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Никитинская О.А., Торопцова Н.В., Демин Н.В. Факторы риска и минеральная плотность кости в прогнозировании риска перелома у женщин в постменопаузе. Современная ревматология. 2016;10(3):23-8. https://doi.org/10.14412/1996-7012-2016-3-23-28.</mixed-citation><mixed-citation xml:lang="en">Nikitinskaya O.A., Toroptsova N.V., Demin N.V. Risk factors and bone mineral density in predicting the risk of fracture in postmenopausal women. [Faktory riska i mineral'naya plotnost' kosti v prognozirovanii riska pereloma u zhenshchin v postmenopauze]. Sovremennaya revmatologiya. 2016;10(3):23-8. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Бирюкова Е.В., Романова Е.В. Постменопаузальный остеопороз: современные возможности лечения и профилактики переломов. Эффективная фармакотерапия. 2011;(5):16-20.</mixed-citation><mixed-citation xml:lang="en">Biryukova E.V., Romanova E.V. Postmenopausal osteoporosis: current treatment and prevention of fractures. [Postmenopauzal'nyj osteoporoz: sovremennye vozmozhnosti lecheniya i profilaktiki perelomov]. Effektivnaya farmakoterapiya. 2011;(5):16-20. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Доброхотова Ю.Э., Дугиева М.З. Постменопаузальный остеопороз: препараты кальция в современной стратегии профилактики и лечения. РМЖ. Мать и дитя. 2017;25(15):1135-9.</mixed-citation><mixed-citation xml:lang="en">Dobrokhotova Yu.E., Dugieva M.Z. Postmenopausal osteoporosis: calcium supplements in current prevention and treatment strategy. [Postmenopauzal'nyj osteoporoz: preparaty kal'ciya v sovremennoj strategii profilaktiki i lecheniya]. RMZh. Mat' i ditya. 2017;25(15):1135-9. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Дымнова С.Е., Сергеева В.В., Родионова А.Ю. Качество жизни и основные аспекты реабилитации больных пожилого возраста с остеопорозом. Вестник современной клинической медицины. 2018;11(6):62-7. https://doi.org/10.20969/VSKM.2018.11(6).62-67.</mixed-citation><mixed-citation xml:lang="en">Dymnova S.E., Sergeeva V.V., Rodionova A.Yu. Quality of life and the main aspects of rehabilitation in patients of advanced age with osteoporosis. [Kachestvo zhizni i osnovnye aspekty reabilitacii bol'nyh pozhilogo vozrasta s osteoporozom]. Vestnik sovremennoj klinicheskoj mediciny. 2018;11(6):62-7. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Пигарова Е.А., Рожинская Л.Я. Современные подходы к диагностике и лечению остеопороза. Consilium Medicum. 2014;16(4):82-7.</mixed-citation><mixed-citation xml:lang="en">Pigarova EA, Rozhinskaya L.Ya. Current approaches to diagnosis and treatment of osteoporosis. [Sovremennye podhody k diagnostike i lecheniyu osteoporoza]. Consilium Medicum. 2014;16(4):82-7. (In Russ.).</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
