CTX (Crosslaps) Rather than Osteopontin Is Associated with Disturbed Glucose Metabolism in Gestational Diabetes

Objective:Reciprocal interaction between bone and glucose metabolism might play a pivotal role in the development of
type 2 diabetes. We recently demonstrated that osteocalcin is increased in women with gestational diabetes (GDM)
compared to healthy pregnant women and related to enhanced insulin secretion. Here, we aimed to investigate the role of
the bone resorption marker CTX and osteopontin (OPN), a key molecule in subclinical inflammation underlying insulin
resistance, in gestational diabetes.
Methods:Insulin sensitivity and secretion (derived from OGTT) as well as CTX and osteopontin were investigated in 26 GDM
and 52 women with normal glucose tolerance during pregnancy [CON] between 24th and 28th gestational weeks; 24
women also underwent postpartum examination.
Results:CTX was significantly higher in GDM compared to CON (0.4460.20 vs.0.2860.12 ng/ml, p,.0001) and positively
correlated with osteocalcin (R = 0.64, p,.0001) and parameters of insulin secretion. Osteopontin plasma concentrations
were decreased in GDM compared to CON (28.81622.12 vs.37.68619.63 ng/ml, p = 0.04), and did not show any relation to
insulin secretion or sensitivity, but were significantly correlated with CRP (R = 0.3, p,0.007) and liver enzymes. Twelve weeks
after delivery CTX and OPN were increased compared to pregnancy (both p,.0001) and did not differ between GDM and
CON.
Conclusion:Our findings support the idea of a tight regulation between bone and glucose metabolism, and suggest, that
less curbed CTX during pregnancy might be involved in osteocalcin-mediated amelioration of insulin secretion in GDM. On
the other hand, osteopontin was unrelated to insulin resistance in GDM, but associated with inflammatory markers and liver
enzymes in all women.