Regulation of fetal hemoglobin expression during hematopoietic stem cell development and its importance in bone metabolism and osteoporosis

Association Between Hemoglobin Levels and Osteoporosis in Chinese Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

PURPOSE

To explore the relationship between hemoglobin levels and osteoporosis and the risk factors for osteoporosis in patients with type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS

A cross-sectional study was conducted in 495 T2DM adults. Medical data were collected from electronic medical records.

RESULTS

T2DM patients with osteoporosis had significant lower hemoglobin levels (P < 0.001). Spearman correlation analysis and logistic regression analysis showed that age, female, body mass index (BMI), smoking, drinking and hemoglobin levels were significantly associated with osteoporosis in T2DM patients (all P < 0.05). After adjustment for BMI, diabetic duration, estimated glomerular filtration rate (eGFR), smoking and drinking, a significant association between hemoglobin levels and osteoporosis was observed in T2DM males aged 50 years and older (odds ratio [OR] = 0.978, 95% confidence interval [CI]: 0.958-0.998, P = 0.030). Compared to Q3 groups with normal hemoglobin levels, Q1 groups with anemia had an odd of osteoporosis increased 2.9-fold in T2DM men after adjustment for age, BMI, diabetic duration, eGFR, smoking and drinking (P = 0.032).

CONCLUSION

Hemoglobin levels were associated with the presence of osteoporosis in T2DM men, especially in those aged 50 years and older.

Anemia is related to osteoporosis in Chinese type 2 diabetic patients

Both anemia and osteoporosis are common in type 2 diabetes mellitus (T2DM). However, the relationship between them remains to be determined. This study showed that anemia was related to osteoporosis in male and female T2DM patients. Diabetes patients with anemia should also be wary of osteoporosis.

INTRODUCTION

Anemia and osteoporosis are considered complications of type 2 diabetes mellitus (T2DM). However, the relationship between anemia and osteoporosis in the T2DM population remains to be determined. Thus, we planned the present study to verify their relationship.

METHODS

A retrospective cross-sectional study was performed. The patients were divided into groups according to sex and hemoglobin levels (Q1: ≤ 120, Q2: 120 to ≤ 140, Q3: > 140 in men; Q1: ≤ 110, Q2: 110 to ≤ 130, Q3: > 130 in women). Clinical characteristics and bone mineral density (BMD) were compared. The relationship between anemia and osteoporosis was determined after adjusting for age, diabetic duration, body mass index, alanine aminotransferase, creatinine, HbA1c, and fasting C-peptide. Statistical analysis was performed using SPSS 26.0.

RESULTS

This study included 2336 patients (1150 men and 1186 postmenopausal women). The percentage of osteoporosis differed by hemoglobin status in both men (Q1: 20.2%, Q2: 15.5%, Q3: 12.4%, P = 0.031) and women (Q1: 51.4%, Q2: 38.0%, Q3: 34.5%, P < 0.001). Q1, with the lowest hemoglobin level, has higher percentage of osteoporosis in men (20.2%) and in women (51.4%). Hip BMD (men: r = 0.168, P < 0.001, women: r = 0.126, P < 0.001) and femur neck BMD (men: r = 0.150, P < 0.001, women: r = 0.134, P < 0.001) were correlated with hemoglobin levels in both sexes. The odds of osteoporosis increased 1.4-fold in men and 2.0-fold in women in the Q1 groups compared with Q3 groups.

CONCLUSION

Anemia was related to osteoporosis in T2DM patients regardless of sex. Diabetic patients with anemia (men with hemoglobin below 120 g/L and women with hemoglobin below 110 g/L) should also be wary of osteoporosis.

The impact of indole-3-lactic acid on immature intestinal innate immunity and development: a transcriptomic analysis

An excessive intestinal inflammatory response may have a role in the pathogenesis of necrotizing enterocolitis (NEC) in very preterm infants. Indole-3-lactic acid (ILA) of breastmilk tryptophan was identified as the anti-inflammatory metabolite involved in probiotic conditioned media from Bifidobacteria longum subsp infantis. This study aimed to explore the molecular endocytic pathways involved in the protective ILA effect against inflammation. H4 cells, Caco-2 cells, C57BL/6 pup and adult mice were used to compare the anti-inflammatory mechanisms between immature and mature enterocytes in vitro and in vivo. The results show that ILA has pleiotropic protective effects on immature enterocytes including anti-inflammatory, anti-viral, and developmental regulatory potentials in a region-dependent and an age-dependent manner. Quantitative transcriptomic analysis revealed a new mechanistic model in which STAT1 pathways play an important role in IL-1β-induced inflammation and ILA has a regulatory effect on STAT1 pathways. These studies were validated by real-time RT-qPCR and STAT1 inhibitor experiments. Different protective reactions of ILA between immature and mature enterocytes indicated that ILA’s effects are developmentally regulated. These findings may be helpful in preventing NEC for premature infants.