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Ferro Y, Russo C, Russo D, Gazzaruso C, Coppola A, Gallotti P, Zambianchi V, Fodaro M, Romeo S, Galliera E, Marazzi MG, Romanelli MMC, Giannini S, Pujia A, Montalcini T. Association between low C-peptide and fragility fractures in postmenopausal women without diabetes. J Endocrinol Invest 2017; 40:1091-1098. [PMID: 28401528 DOI: 10.1007/s40618-017-0672-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/04/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE C-peptide has been shown to exert several, previously unknown, biological effects. A recent cross-sectional study demonstrated an association between low C-peptide serum levels and low lumbar bone density of postmenopausal women not affected by diabetes. To date, very little research attention has been directed toward the association between C-peptide and osteoporotic fractures. To contribute toward filling this gap, we investigated the association between C-peptide and fractures in postmenopausal women. METHODS A cohort of 133 non-diabetic postmenopausal women with and without a history of fractures was evaluated in this cross-sectional investigation. Standardized interviews were performed to gather information on the patients' fracture history. All of the participants underwent a bone mineral density assessment by DXA, radiographs, and a serum C-peptide measurement. RESULTS Thirty-four women presented fractures. Bivariate analysis revealed an inverse correlation between C-peptide and fractures (r = -0.27, p = 0.002). A significant difference in mean C-peptide levels was also found between women with vs. without fractures (p = 0.01, adjusted for age, BMI and glucose). Logistic regression analysis showed that C-peptide levels, femoral and vertebral BMD were all negatively associated with fracture status (B = -1.097, ES = 0.401, p = 0.006, 95% CI 0.15-0.73; B = -15.6, SE = 4.17, p < 0.001, CI 0.001-0.002; B = -24.8, SE = 5.23, p < 0.001, CI 0001-0.002; respectively). CONCLUSIONS This study confirms an inverse association between serum C-peptide levels and a history of fractures in postmenopausal women without diabetes. These results suggest that C-peptidemay exert an effect on bone mineral density. However, further large-scale studies are needed to corroborate this finding and investigate the potential underlying mechanisms involved.
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Affiliation(s)
- Y Ferro
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy
| | - C Russo
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy
| | - D Russo
- Department of Health Science, University Magna Graecia, Catanzaro, 88100, Italy
| | - C Gazzaruso
- Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - A Coppola
- Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - P Gallotti
- Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - V Zambianchi
- Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - M Fodaro
- Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - S Romeo
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy
- Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascolar and Metabolic Research, University of Gothenburg, Göteborg, 42246, Sweden
| | - E Galliera
- Department of Biomedical, Surgical and Dental Science, University of Milan and Orthopaedic Institute IRCCS Galeazzi, 20161, Milan, Italy
| | - M G Marazzi
- Department of Health Biomedical Science, University of Milan and Unit of SMEL-1 Clinical Pathology Unit, San Donato Hospital IRCCS, San Donato Milanese, 20097, Milan, Italy
| | - M M C Romanelli
- Department of Health Biomedical Science, University of Milan and Unit of SMEL-1 Clinical Pathology Unit, San Donato Hospital IRCCS, San Donato Milanese, 20097, Milan, Italy
| | - S Giannini
- Department of Medical and Surgical Sciences, University of Padova, 35128, Padua, Italy
- National Research Council, Center for Aging Studies of Padova, 35128, Padua, Italy
| | - A Pujia
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy
| | - T Montalcini
- Menopause Clinic, Department of Clinical and Experimental Medicine, University Magna Graecia, Campus Universitario Germaneto, Viale S. Venuta, floor III, Catanzaro, 88100, Italy.
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