ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1646690
This article is part of the Research TopicDiabetes Complications: Navigating Challenges and Unveiling New SolutionsView all 13 articles
Relationship between bone turnover markers and diabetic kidney disease in patients with type 2 diabetes
Provisionally accepted
- 1The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- 2University of South China Hengyang Medical School, Hengyang, China
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Objective: Diabetic kidney disease (DKD) is one of the most serious complications of type 2 diabetes mellitus (T2DM), and bone metabolism disorders show a close linkage to DKD. Thus, this study aimed to explore the association between bone turnover markers (BTMs) and DKD. Methods: In present cross-sectional study, serum BTMs were detected in 1433 hospitalized patients with T2DM. Logistic regression analysis was used to investigate the associations between osteocalcin (N-MID), β-cross-linked C-telopeptide (β-CTX), total type I collagen N-terminal propeptide (PINP), and the risk of DKD. Results: The circulation N-MID, β-CTX, and PINP levels were significantly lower in the DKD group compared with the non-DKD group (all P < 0.05), especially in male and aged < 60 subgroups. Serum BTM levels showed a weak correlations with certain glucose metabolism parameters–such as glycated hemoglobin, fasting blood glucose, C peptide, and fasting insulin−as well as alkaline phosphatase (ALP) levels and low-density lipoprotein (all P < 0.001). A weak negative correlation was also observed with the duration of diabetes (all P < 0.0001). In addition, β-CTX levels showed a minimal positive correlation with eGFR (r = 0.057, P = 0.036) and a modest correlation with ALP (r = 0.31, P < 0.0001). After adjusting for potential confounders, higher serum β-CTX levels were independently associated with a lower risk of DKD. However, no significant associations were found among serum N-MID, PINP, and the risk of DKD. Conclusion: BTM levels were significantly decreased in patients with DKD. Lower β-CTX levels were independently associated with a larger prevalence of DKD after adjusting for potential confounders, suggesting that serum β-CTX may be an independent marker associated with the risk of DKD.
Keywords: Diabetic kidney disease, Bone turnover markers, β-cross-linked C-telopeptide, Risk factors, type 2 diabetes
Received: 13 Jun 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Men, Yue, Hao, Zhang, Chen and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xueyan Men, menxueyan2019@163.com
En Chen, 2018012470@usc.edu.cn
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