Osteocalcin: An Endocrine Link Between Bone and Glucose Metabolism

Bu B Yeap

Disclosures

Expert Rev Endocrinol Metab. 2011;6(2):177-185. 

In This Article

Studies of ucOC, Insulin Resistance & Diabetes in Humans

The studies summarized so far[23–30] are limited by their use of TOC and not ucOC assays, which limits their direct applicability to the mechanisms demonstrated by Karsenty et al. in mice and cells.[17,18,21] Fewer studies have assessed ucOC and these have been much smaller in size, as demonstrated in Table 2. Hwang et al. reported a cross-sectional study of 199 middle-aged men in which ucOC values in the highest tertile were associated with a greater prevalence of diabetes.[31] In the study by Shea et al., lower carboxylated osteocalcin was associated with insulin resistance while lower ucOC was not.[32] However, a lower percentage of ucOC/TOC at baseline predicted a greater increase in insulin resistance in a subset of subjects followed for 3 years.[32] In 50 adults with poorly controlled Type 2 diabetes, 1 month of treatment intensification resulted in increased TOC levels and a lower ucOC/TOC ratio.[33] In a cross-sectional study of 180 men and 109 postmenopausal women with Type 2 diabetes, Kanazawa et al. found that both TOC and ucOC correlated negatively with fasting glucose and glycated hemoglobin in men, while TOC correlated negatively with fasting glucose in women.[34] Therefore, there are limited data supporting the relationship of reduced ucOC with abnormal glucose metabolism in humans, and these do not clearly distinguish between associations of insulin resistance and diabetes with ucOC specifically, as opposed to bone turnover reflected in TOC levels.[19] In addition, there are no data examining whether ucOC level predicts the key outcome of CVD-related morbidity and mortality.

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