Plasma F2-Isoprostanes Linked to Higher Fracture Risk in Older Type 2 Diabetes Patients

Plasma F2-Isoprostanes Linked to Higher Fracture Risk in Older Type 2 Diabetes Patients

November 22, 2024 Catherine Williams - Chief Editor Tech

TOPLINE:

High levels of plasma F2-isoprostanes, a marker of oxidative stress, may increase fracture risk in older patients with type 2 diabetes (T2D), regardless of bone density.

METHODOLOGY:

  • Patients with T2D have a higher fracture risk at any bone mineral density. Elevated oxidative stress, marked by F2-isoprostanes, may weaken bone integrity.
  • Researchers analyzed an observational study to explore the link between F2-isoprostane levels and fracture risk in older adults with T2D.
  • The study included 703 older ambulatory adults (ages 70-79), with a roughly equal split between White and Black individuals, as well as men and women. Out of these, 132 had T2D.
  • Plasma F2-isoprostane levels were determined from initial serum samples. Bone turnover markers, such as procollagen type 1 N-terminal propeptide, osteocalcin, and C-terminal telopeptide of type 1 collagen, were also measured.
  • Researchers tracked clinical fractures over a follow-up period of up to 17.3 years, confirming fractures through radiology reports.

TAKEAWAY:

  • In the T2D group, 25.8% reported a clinical fracture during an average follow-up of 6.2 years. In the non-diabetes group, 23.5% reported fractures during an average of 8.0 years.
  • The fracture risk in T2D patients increased by 93% for each standard deviation increase in log F2-isoprostane levels (hazard ratio [HR] 1.93; 95% CI 1.26-2.95; P = .002). This association was not found in non-T2D individuals (HR 0.98; 95% CI 0.81-1.18; P = .79).
  • Higher plasma F2-isoprostane levels correlated with a decrease in total hip bone mineral density over 4 years in the T2D group (r = −0.28; P = .008) but not in the non-diabetes group.
  • No link was observed between plasma F2-isoprostane levels and advanced glycoxidation end-products, bone turnover markers, or A1c levels in either group.

IN PRACTICE:

“Oxidative stress in T2D may contribute significantly to the decline of bone quality, not just quantity,” noted the authors.

SOURCE:

This study, led by Bowen Wang, PhD, from Rensselaer Polytechnic Institute, was published in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The study involved a healthy elderly population, primarily White and Black, limiting the applicability of findings to other demographics. It also did not assess vertebral fracture risk due to sample size constraints.

DISCLOSURES:

The study received support from the US National Institute on Aging, the NIH Intramural Research Program, and the Sands Family for Orthopaedic Research. The authors reported no conflicts of interest.