The role of osteocalcin in mechanism of Steroid induced diabetes mellitus
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ORIGINAL ARTICLE
The role of osteocalcin in mechanism of Steroid induced diabetes mellitus Holla Avinash 1 & Vidyasagar Sudha 1 & Bairy Laxminarayan 2 & B. Nandakrishna 1 & B. A. Shastry 1 & Kamath Asha 3 & Manjunath Hande 1 & Adiga Shalini 4 Received: 28 May 2019 / Accepted: 26 December 2019 # Research Society for Study of Diabetes in India 2020, corrected publication 2020
Abstract Background Steroids induced diabetes (SID), may be due to either insulin resistance (IR) or beta cell dysfunction or combination of both. Several studies have established that these effects of steroids may be mediated by an osteoblast derived protein called osteocalcin (OC). However, this effect has been described only in diabetic patients and has not been studied in SID patients. Aim and study design A prospective observational cohort study was designed to evaluate the correlation between serum OC level and blood glucose profile, in patients on steroids. Results Out of a total of 88 subjects who were on steroid therapy, 42(47.7%) subjects had their blood sugar levels in the diabetic range. Based on the glycemic status, subjects were divided into three groups, namely, normoglycemic, pre-diabetes and diabetes. The patients who developed SID were older than normoglycemic (mean age 43.15 vs 39.27years). The age (r=-0.105 p=0.5), BMI (r=-0.3 p= 0.07) and abdominal obesity (r=-0.32 p=0.04) were negatively correlated with serum osteocalcin in diabetes group. Serum osteocalcin level decreased as dose of steroid increased in all three groups (normogylcemic r=-0.701 p=0.004 prediabetes r=-0.3 p=0.07 diabetes -0.362 p=0.04). Fasting plasma glucose (r=-0.319 p=0.04), Fasting insulin (r=-0.10 p=0.5) and IR (r=-0.194 p=0.212) were increased with decrease in OC in patients in diabetes group. Conclusion Decrease in serum osteocalcin level with increase in glycemic parameters in steroid induced diabetes group, point to have a new role in mechanism of steroid induced diabetes. This may be a novel target to discover drugs that can maintain the OC levels so that the effect of steroids on blood sugar level can be minimised. Keywords Steroid-induced diabetes . Insulin resistance . Serum osteocalcin . Fasting insulin
Introduction Since their introduction in 1950, steroids are commonly used in the treatment of both acute and chronic illnesses owing to their anti-inflammatory effects . They have * Vidyasagar Sudha [email protected] 1
Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi District Karnataka 576104, India
2
Pharmacology RAK College of Medical Science, Ras Al Khaimah, UAE
3
Department of Statistics, Prasanna School at Public Health, Manipal Academy of Higher Education, Manipal, India
4
Department of Pharmacology Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi District Karnataka 576104, India
many side effects, common among them hyperglycemia. The hyperglycemic effect of the steroids is one of the limiting factors to their clinical use [1, 2] Steroids increase
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