Diabetic
osteopenia, a known chronic complication of diabetes, has been demonstrated with alterations in the
calcium-
vitamin D endocrine system. In order to investigate the relationship between the decrease of bone density and the altered
mineral metabolism in
non-insulin-dependent diabetes mellitus (
NIDDM), 104 male clinical-proven
NIDDM patients were studied. All patients were examined on metacarpal bone mineral density (m-BMD) by means of computed X-ray densitometry (CXD) methods. The values of the Z-score of m-BMD were significantly lower than those of age-matched controls (P<0.01). There was a positive correlation between m-BMD and serum
calcium levels (P<0.01), but a negative correlation was conversely observed between m-BMD and serum intact
parathyroid hormone (PTH) (P<0.01), indicating that the negative
calcium balance under diabetic conditions could cause the decrease of m-BMD in
NIDDM. Interestingly, since a significantly positive correlation was found between circulating levels of
calcium and
parathyroid hormone-related peptide (
PTHrP) (P<0.05) but not PTH, it seems likely that
PTHrP plays a more compensatory role on the maintenance of
calcium homeostasis than PTH under diabetic conditions. Based on these observations, the CXD method would be useful in measuring the
mineral density of cortical bone, and would also be beneficial to investigate underlying pathogenetic mechanism of diabetic
osteopenia.