Jakob Starup-Linde1,2*
1 Faculty of Health, Aalborg University, Aalborg, Denmark
2 Department of Endocrinology and Internal Medicine, Aarhus University Hospital THG, Aarhus, Denmark
Diabetes mellitus is known to have late complications including micro vascular and macro vascular disease. This review focuses on another possible area of complication regarding diabetes; bone. Diabetes may affect bone via bone structure, bone density, and biochemical markers of bone turnover.The aim of the present review is to examine in vivo from humans on biochemical markers of bone turnover in diabetics compared to non-diabetics. Further more, the effect of glycemic control on bone markers and the similarities and differences of type 1- and type 2-diabetics regarding bone markers will be evaluated. A systematic literature search was conducted using PubMed, Embase, Cinahl, and SveMed+ with the search terms: “Diabetes mellitus,” “Diabetes mellitus type 1,” “Insulin dependent diabetes mellitus,” “Diabetes mellitus type 2,” “Non-insulin dependent diabetes mellitus,” “Bone,” “Bone and Bones,” “Bone diseases,” “Bone turnover,” “Hemoglobin A Glycosylated,” and “HbA1C.” After removing duplicates from this search 1,188 records were screened by title and abstract and 75 records were assessed by full text for inclusion in the review. In the end 43 records were chosen. Bone formation and resorption markers are investigated as well as bone regulating systems. T1D is found to have lower osteocalcin and CTX, while osteo calcin and tartrate-resistant acid are found to be lower in T2D, and sclerostin is increased and collagen turnover markers altered. Other bone turnover markers do not seem to be altered in T1D or T2D. A major problem is the lack of histomorphometric studies in humans linking changes in turnover markers to actual changes in bone turnover and further research is needed to strengthen this link.
Keywords: diabetes mellitus, bone, bone turnover, markers of bone turnover, biochemical markers, glycemic contro
Huan Tao1 , Adrienne O’Neil 2,3, Yunseon Choi 4 , Wei Wang5 , Junfeng Wang6 , Yafeng Wang7 *, Yongqian Jia1 * and Xiong Chen8 *
1 Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University, Chengdu, China, 2 The Centre for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, VIC, Australia, 3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia, 4 Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea, 5 School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China, 6 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, 7 Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China, 8 Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Objective: The relationship between diabetes and all- and cause-specific mortality in individuals with common cancers (breast, colorectal, and prostate) remains both under-researched and poorly understood.
Methods: Cancer survivors (N = 37,993) from the National Health Interview Survey with linked data retrieved from the National Death Index served as our study participants. Cox proportional-hazards models were used to assess associations between pre- and post-diabetes and all-cause and cause-specific mortality.
Results: Over a median follow-up period of 13 years, 2,350 all-cause, 698 cancer, and 506 CVD deaths occurred. Among all cancer survivors, patients with diabetes had greater risk of: all-cause mortality [hazard ratio (HR) 1.35, 95% CI = 1.27–1.43], cancer-specific mortality (HR: 1.14, 95% CI = 1.03–1.27), CVD mortality (HR: 1.36, 95% CI = 1.18–1.55), diabetes related mortality (HR: 17.18, 95% CI = 11.51–25.64), and kidney disease mortality (HR: 2.51, 95% CI = 1.65–3.82), compared with individuals without diabetes. The risk of all-cause mortality was also higher amongst those with diabetes and specific types of cancer: breast cancer (HR: 1.28, 95% CI = 1.12–1.48), prostate cancer (HR: 1.20, 95% CI = 1.03–1.39), and colorectal cancer (HR: 1.29, 95% CI = 1.10–1.50). Diabetes increased the risk of cancer-specific mortality among colorectal cancer survivors (HR: 1.36, 95% CI = 1.04–1.78) compared to those without diabetes. Diabetes was associated with higher risk of diabetes-related mortality when compared to non-diabetic breast (HR: 9.20, 95% CI = 3.60–23.53), prostate (HR: 18.36, 95% CI = 6.01–56.11), and colorectal cancer survivors (HR: 12.18, 95% CI = 4.17–35.58). Both pre- and post-diagnosis diabetes increased the risk of all-cause mortality among all cancer survivors. Cancer survivors with diabetes had similar risk of all-cause and CVD mortality during the second 5 years of diabetes and above 10 years of diabetes as compared to non-diabetic patients.
Conclusions: Diabetes increased the risk of all-cause mortality among breast, prostate, and colorectal cancer survivors, not for pre- or post-diagnosis diabetes. Greater attention on diabetes management is warranted in cancer survivors with diabetes.
Keywords: diabetes, all-cause, cancer, cardiovascular disease, mortality, cohort study
擅长：1. 烧伤/烫伤/手术疤痕美学修复; 2. 创面/伤口/溃疡/皮肤缺损美学修复; 3. 全身体表肿瘤/包块手术治疗。
擅长疾病：1.面部轮廓整形;2.面部年轻化;3.身体塑形;4.先天性和创伤后畸形修复、体表肿瘤切除及器官再造。如：黄褐斑、瘢痕疙瘩、减肥 。教授，整形外科副主任，医学博士后，毕业于西安第四军医大学临床医学系，毕业后留校。
在成人大面积烧伤的休克复苏、感染防治、多器官功能障碍综合征的防治、严重电烧伤和吸入性损伤的救治以及小儿重度和特重度烧伤的救治等方面有较高造诣。获黑龙江省科技进步三等奖2项，哈尔滨市科技进步二等奖1项，三等奖2项。
担任欧洲糖尿病学会会员、美国糖尿病学会会员、欧洲糖尿病学会糖尿病足研究组发起会员、中华医学会糖尿病学分会第2届足病学组组长、中国人民解放军内分泌学会副主任委员、北京内分泌学会副主任委员、北京糖尿病防治协会副理事长、北京市朝阳区预防医学会副会长、国家卫生部全国慢性病综合防治示范点专家组成员、中国疾病控制中心慢病中心糖尿病专家、第四军医大学兼职教授，悉尼大学客座教授，第四军医大学硕士研究生导师，中南大学湘雅三医院硕士研究生导师主任医师。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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