The Relationship between Trace Elements, High sensitivity C - Reactive Protein and Bone Mineral Density in Elderly Diabetic Patients

Abstract

Diabetes mellitus is a metabolic disorder with inappropriate hyperglycemia either due to an absolute or relative deficiency of insulin secretion or reduction in the biologic effectiveness of insulin or both. It is also associated with disturbances concerned with protein, carbohydrate and lipid metabolism. Trace element deficiencies are frequently associated with chronic diseases or problems with their absorption. Chronic hyperglycemia may cause significant alterations in the status of some micronutrients and on the other hand some of these micronutrients can directly modulate glucose homeostasis and promote the development of diabetic complications. Decreased bone density has been reported as a complication of insulin dependent DM especially those with poorly controlled disease. However, controversial findings were reported on the effect of type 2 diabetes mellitus (T2DM) on bone mineral density (BMD). Mg, Zn and Cu are essential cofactors for enzymes involved in synthesis of various bone matrix constituents. So, their deficiencies due to reduced dietary intake and reduced absorption of these micronutrients in elderly may lead to bone density loss and osteoporosis. Several studies demonstrated that hs-CRP is a significant predictor of diabetes risk even after adjusting for other factors and found to be increased in patients with hyperglycemia especially uncontrolled type 2 diabetic subjects. Higher serum levels of hs-CRP are associated with lower BMD, higher levels of bone turnover markers and greater risk of fracture. The aim of this study was to clarify the relationship between trace elements (Zn, Cu, and Mg), hs-CRP and bone mineral density in elderly type 2 diabetic patients. It is a case control study carried out on 100 elderly