ArticleEndocrine connections2022
Thyroid and bone turnover markers in type 2 diabetes: results from the METAL study.
Article in Endocrine connections, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Assessment of P1NP and β-CTX in Type 2 Diabetes Mellitus: a Case-Control Study from North India.Maedica · 2026Article
- Association of high-density lipoprotein with P1NP and β-CTX in hospitalized patients with osteoporotic fractures: a retrospective cross-sectional study.Frontiers in endocrinology · 2026Article
- Correlation between thyroid sensitivity indices and bone metabolism in newly diagnosed middle aged and elderly patients with type 2 diabetes mellitus with normal thyroid function.BMC endocrine disorders · 2025Article
- Association between fibrinogen-to-albumin ratio and bone metabolism markers (β-CTX and P1NP) in Chinese individuals with osteoporotic fracture: a cross-sectional investigation.BMC musculoskeletal disorders · 2025Observational
- Type 2 diabetes and bone fragility in children and adults.World journal of diabetes · 2022Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
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Abstract
Objective: We aimed to evaluate whether thyroid hormones, autoimmune and thyroid homeostasis status were related to bone turnover in type 2 diabetes. Methods: The data were obtained from a cross-sectional study, the METAL study. In this study, 4209 participants (2059 men and 2150 postmenopausal women) with type 2 diabetes were enrolled. Thyroid function, thyroid antibodies and three bone turnover markers (BTMs), including a large N-mid fragment of osteocalcin (N-MID osteocalcin), β-C-terminal cross-linked telopeptides of type I collagen (β-CTX) and procollagen type I N-terminal propeptide (P1NP), were measured. Thyroid homeostasis parameters, including the sum activity of step-up deiodinases (SPINA-GD), thyroid secretory capacity (SPINA-GT), Jostel's TSH index (TSHI) and the thyrotroph thyroid hormone resistance index (TTSI), were calculated. The associations of thyroid parameters with BTMs were analyzed using linear regression. Results: Free and total triiodothyronine were positively associated with N-MID osteocalcin and P1NP in both sexes and positively associated with β-CTX in postmenopausal women. Thyroid-stimulating hormone was negatively associated with β-CTX in postmenopausal women, and free thyroxine was negatively associated with N-MID osteocalcin and P1NP in men. SPINA-GD was positively associated with N-MID osteocalcin and P1NP in both sexes. There was a positive relationship of SPINA-GT with β-CTX, a negative relationship of TTSI with β-CTX, and a negative relationship of TSHI with β-CTX and P1NP in postmenopausal women. Conclusions: Among men and postmenopausal women with type 2 diabetes, significant associations were observed between N-MID osteocalcin, β-CTX and P1NP with thyroid function and thyroid homeostasis. Further prospective studies are warranted to understand the causal relationship and underlying mechanism.
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