Effects of a Lifestyle Intervention on Bone Turnover in Persons with Type 2 Diabetes: A post hoc Analysis of the U-TURN Trial
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Effects of a Lifestyle Intervention on Bone Turnover in Persons with Type 2 Diabetes : A post hoc Analysis of the U-TURN Trial. / Abildgaard, Julie; Johansen, Mette Yun; Skov-Jeppesen, Kirsa; Andersen, Lars Bo; Karstoft, Kristian; Hansen, Katrine Bagge; Hartmann, Bolette; Holst, Jens Juul; Pedersen, Bente Klarlund; Ried-Larsen, Mathias.
In: Medicine and Science in Sports and Exercise, Vol. 54, No. 1, 2022, p. 38-46.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effects of a Lifestyle Intervention on Bone Turnover in Persons with Type 2 Diabetes
T2 - A post hoc Analysis of the U-TURN Trial
AU - Abildgaard, Julie
AU - Johansen, Mette Yun
AU - Skov-Jeppesen, Kirsa
AU - Andersen, Lars Bo
AU - Karstoft, Kristian
AU - Hansen, Katrine Bagge
AU - Hartmann, Bolette
AU - Holst, Jens Juul
AU - Pedersen, Bente Klarlund
AU - Ried-Larsen, Mathias
N1 - Copyright © 2021 American College of Sports Medicine.
PY - 2022
Y1 - 2022
N2 - Introduction/Purpose.The increased risk of fractures with type 2 diabetes (T2D) is suggested to be caused by decreased bone turnover. Current international guidelines recommend lifestyle modifications, including exercise, as first-line treatment for T2D. The aim of this study was to investigate the effects of an exercise-based lifestyle intervention on bone turnover and bone mineral density (BMD) in persons with T2D.METHODS: Persons with T2D were randomized to either a 12-months lifestyle intervention (n = 64) or standard care (n = 34). The lifestyle intervention included five to six weekly aerobic training sessions, half of them combined with resistance training. Serum markers of bone turnover (osteocalcin (OC), N-terminal propeptide of type-I procollagen (PINP), reflecting bone formation, and carboxyterminal collagen I crosslinks (CTX-I), reflecting bone resorption) and BMD (by DXA) were measured before the intervention and at follow-up.RESULTS: From baseline to follow-up, s-PINP increased by 34 % (95 % CI: 17 - 50 %), s-CTX-I by 36 % (95 % CI: 1 - 71 %), and s-OC by 31 % (95 % CI: 11 - 51 %) more in the lifestyle intervention group compared with standard care. Loss of weight and fat mass were the strongest mediators of the increased bone turnover. BMD was unaffected by the intervention ([INCREMENT] BMD: 0.1 %, 95 % CI: -1.1 to 1.2 %).CONCLUSIONS: A 12-months intensive exercise-based lifestyle intervention led to a substantial but balanced increase in bone turnover in persons with T2D. The increased bone turnover combined with a preserved BMD, despite a considerable weight loss, is likely to reflect improved bone health and warrants further studies addressing the impact of exercise on risk of fractures in persons with T2D.
AB - Introduction/Purpose.The increased risk of fractures with type 2 diabetes (T2D) is suggested to be caused by decreased bone turnover. Current international guidelines recommend lifestyle modifications, including exercise, as first-line treatment for T2D. The aim of this study was to investigate the effects of an exercise-based lifestyle intervention on bone turnover and bone mineral density (BMD) in persons with T2D.METHODS: Persons with T2D were randomized to either a 12-months lifestyle intervention (n = 64) or standard care (n = 34). The lifestyle intervention included five to six weekly aerobic training sessions, half of them combined with resistance training. Serum markers of bone turnover (osteocalcin (OC), N-terminal propeptide of type-I procollagen (PINP), reflecting bone formation, and carboxyterminal collagen I crosslinks (CTX-I), reflecting bone resorption) and BMD (by DXA) were measured before the intervention and at follow-up.RESULTS: From baseline to follow-up, s-PINP increased by 34 % (95 % CI: 17 - 50 %), s-CTX-I by 36 % (95 % CI: 1 - 71 %), and s-OC by 31 % (95 % CI: 11 - 51 %) more in the lifestyle intervention group compared with standard care. Loss of weight and fat mass were the strongest mediators of the increased bone turnover. BMD was unaffected by the intervention ([INCREMENT] BMD: 0.1 %, 95 % CI: -1.1 to 1.2 %).CONCLUSIONS: A 12-months intensive exercise-based lifestyle intervention led to a substantial but balanced increase in bone turnover in persons with T2D. The increased bone turnover combined with a preserved BMD, despite a considerable weight loss, is likely to reflect improved bone health and warrants further studies addressing the impact of exercise on risk of fractures in persons with T2D.
U2 - 10.1249/MSS.0000000000002776
DO - 10.1249/MSS.0000000000002776
M3 - Journal article
C2 - 34431828
VL - 54
SP - 38
EP - 46
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
SN - 0195-9131
IS - 1
ER -
ID: 279260195