BackgroundHere we study the effect of type 2 diabetes (T2DM) on bone cell precursors, turnover and cytokines involved in the control of bone cell formation and activity.MethodsWe enrolled in the study 21 T2DM women and 21 non diabetic controls matched for age and body mass index (BMI). In each subject we measured bone cell precursors, Receptor Activator of Nuclear Factor κB (RANKL), Osteoprotegerin (OPG), Sclerostin (SCL) and Dickoppf-1 (DKK-1) as cytokines involved in the control of osteoblast and osteoclast formation and activity, bone density (BMD) and quality trough trabecular bone score (TBS) and bone turnover. T2DM patients and controls were compared for the analyzed variables by one way ANOVA for Gaussian ones and by Mann-Whitney or Kruskal-Wallis test for non-Gaussian variables.ResultsRANKL was decreased and DKK-1 increased in T2DM. Accordingly, patients with T2DM have lower bone turnover compared to controls. BMD and TBS were not significantly different from healthy controls. Bone precursor cells were more immature in T2DM. However the number of osteoclast precursors was increased and that of osteoblasts decreased.ConclusionsPatients with T2DM have more immature bone cells precursors, with increased number of osteoclasts and decreased osteoblasts, confirming low bone turnover and reduced cytokines such as RANKL and DKK-1. BMD and TBS are not significantly altered in T2DM although, in contrast with other studies, this may be due to the match of patients and controls for BMI rather than age.

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We report the prevalence of osteoporosis, osteopenia, and fractures in a cohort of Italian women randomly recruited among the general population and validate the use of clinical guidelines in referring women for bone density testing. We enrolled in the study 995 healthy women (age range 45-92 years). A bone density test at the lumbar spine and femur was performed and a questionnaire on osteoporosis risk factors completed for all patients. The prevalence of osteoporosis was 33.67 %, that of osteopenia was 46.63, and 19.7 % were normal at bone density testing. Osteoporotic women were generally older and thinner, with a shorter period of estrogen exposure. The prevalence of fractures was 21.9 %, and fractured women had a lower bone density, were older, and had a longer postmenopausal period. Clinical guidelines for referring women for bone density testing performed poorly (the best performance was 68 %). This is the first study providing data on the prevalence of osteoporosis/osteopenia and of fractures in a cohort of healthy postmenopausal women. Known risk factors influence bone density and risk of fractures. The role of screening in detecting women with postmenopausal osteoporosis is far from optimal.

Abstract.Purpose. The aim of this study is to assess the effect of PTH on Wnt10b production by immune system cells in humans. We assessed both the effect of intermittent PTH administration (iPTH) and of chronic PTH hyper secretion in primary hyperparathyroidism (PHP).Methods. Eighty-two women affected by post-menopausal osteoporosis were randomly assigned to treatment with calcium and vitamin D alone (22) The effect of chronic elevation of PTH was evaluated in 20 patients affected by PHP at diagnosis and after surgical removal of parathyroid adenoma.WNT10b from both osteoporotic and PHP patients was compared to healthy subjects matched for age and sex.Results. iPTH increases Wnt10b production by T cells, whereas PHP does not. After surgical restoration of normal parathyroid function, WNT10b decreases, although it is still comparable with healthy subjects level. Thus chronic elevation of PTH does not significantly increase WNT10b production as respect to control.Conclusions. This is the first work showing the effect of both intermittent and chronic PTH increase on Wnt10b production by immune system cells. We suggest that, in humans, T cells amplified the anabolic effect of PTH on bone, by increasing Wnt10b production, which stimulates osteoblast activity.Key words: osteoporosis, primary hyperparathyroidism, PTH, Wnt10b, T cells, immune system. Mini Abstract.We evaluated the effect of PTH on Wnt10b production by immune system cells in humans.We showed that bone anabolic effect of intermittent PTH treatment may be amplified by T cells through increased production of Wnt10b. Chronic increase in PTH as in primary hyperparathyroidism does not increase Wnt10b expression. INTRODUCTION.