Bone turnover and metabolite responses to exercise in people with and without long-duration type 1 diabetes: a case-control study

Taylor, Guy, Moser, Othmar, Smith, Kieran, Shaw, Andy, Tang, Jonathan C Y, Fraser, William, Eckstein, Max L., Aziz, Faisal, Stevenson, Emma, Shaw, James and West, Daniel (2020) Bone turnover and metabolite responses to exercise in people with and without long-duration type 1 diabetes: a case-control study. BMJ Open Diabetes Research and Care. ISSN 2052-4897 (In Press)

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Abstract Introduction: Exercise acutely alters markers of bone resorption and formation. As fracture risk is increased in patients with type 1 diabetes, understanding if exercise-induced bone turnover is affected within this population is prudent. We assessed bone turnover responses to acute exercise in individuals with long-duration type 1 diabetes and matched controls. Research Design and Methods: Type 1 diabetes participants (n=15; age: 38.7±13.3, HbA1c: 60.5±6.7mmol/mol; diabetes duration: 19.3±11.4years) and age-, fitness-, BMI-matched controls (n=15) completed 45 minutes of incline walking (60%VO2peak). Blood samples were collected at baseline and immediately, 30, and 60 minutes post-exercise. Markers of bone resorption (type-1 cross-linked ꞵ-C-telopeptide [ꞵ-CTx]) and formation (procollagen type-1 N-terminal propeptide [P1NP]), parathyroid hormone (PTH), phosphate, and calcium (albumin-adjusted and ionised) were measured. Data (mean±SD) were analysed by a mixed-model ANOVA. Results: Baseline concentrations of P1NP and ꞵ-CTx were comparable between type 1 diabetes participants and controls. P1NP did not change with exercise (p=0.20) but ꞵ-CTx decreased (p<0.001) in both groups, but less so in type 1 diabetes participants compared to controls (-9.2±3.7%; p=0.02). PTH and phosphate increased immediately post-exercise in both groups; PTH only, was raised at 30 minutes post-exercise, (p<0.001) with no between-group differences (p>0.39). Type 1 diabetes participants had reduced albumin and ionised calcium at all sample points (p<0.01). Conclusions: Following exercise, type 1 diabetes participants displayed similar time course changes in markers of bone formation, associated metabolites, but an attenuated suppression in bone resorption. The reduced albumin and ionised calcium may have implications for future bone health. Further investigation of the interactions between type 1 diabetes, differing modalities and intensities of exercise, and bone health is warranted.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 22 Sep 2020 23:58
Last Modified: 14 Oct 2020 23:58

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