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Background <p>Poor glycaemic control in type 2 diabetes is associated with low bone turnover and skeletal fragility. Osteocalcin has been linked to glucose homeostasis, but its short-term response to rapid improvement in chronic hyperglycaemia in adults remains insufficiently described.</p> Methods <p>We conducted a single-centre observational comparative study in adults with type 2 diabetes. Group 1 had chronic poor control (HbA1c &gt; 8.5% for at least 6 months) and underwent individualised treatment optimisation over 3 months as part of routine care. Group 2 had stable good control (HbA1c &lt; 7% for at least 6 months) and served as a reference group for temporal stability. Total serum osteocalcin was measured at baseline (T0) and at 3 months (T3) and is reported in ng/mL. Body weight was retrieved retrospectively from the medical records. Analyses were exploratory.</p> Results <p>Sixty participants were included (mean age 52 +/- 9 years; 50% women). Baseline osteocalcin concentrations were similar in Group 1 and Group 2 (12.4 +/- 4.3 vs. 12.5 +/- 3.9 ng/mL; between-group mean difference − 0.1 ng/mL, 95% CI -2.2 to 2.0). In Group 1, osteocalcin increased from 12.4 +/- 4.3 to 20.4 +/- 4.8 ng/mL (absolute mean change + 8.0 ng/mL; <i>p</i> &lt; 0.0001), whereas Group 2 remained stable (12.5 +/- 3.9 to 12.8 +/- 3.7 ng/mL; absolute mean change + 0.3 ng/mL; <i>p</i> = 0.94). At 3 months, Group 1 osteocalcin exceeded Group 2 by 7.6 ng/mL (95% CI 5.4 to 9.8). Overall body weight increased descriptively from 79 +/- 3&#xa0;kg at baseline to 81 +/- 2.4&#xa0;kg at 3 months.</p> Conclusions <p>Rapid improvement in glycaemic control was associated with increased circulating total osteocalcin over 3 months in chronically poorly controlled type 2 diabetes, while osteocalcin remained stable in a well-controlled reference group. Because the study was observational and important treatment, weight and lifestyle confounders were incompletely captured, the findings should be interpreted as hypothesis-generating rather than causal.</p> Trial registration <p>ClinicalTrials.gov NCT04893135; first posted 19 May 2021.</p>

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Rapid improvement in glycaemic control is associated with increased circulating osteocalcin in type 2 diabetes: a concise observational comparative study

  • 期刊论文

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  • 发表日期：

    2026年4月16日

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  • Dured Dardari,
  • Francois-Xavier Laborne,
  • Claire Thomas,
  • Caroline Tourte,
  • Elodie Henry,
  • Philippe Lopes

摘要

Background

Poor glycaemic control in type 2 diabetes is associated with low bone turnover and skeletal fragility. Osteocalcin has been linked to glucose homeostasis, but its short-term response to rapid improvement in chronic hyperglycaemia in adults remains insufficiently described.

Methods

We conducted a single-centre observational comparative study in adults with type 2 diabetes. Group 1 had chronic poor control (HbA1c > 8.5% for at least 6 months) and underwent individualised treatment optimisation over 3 months as part of routine care. Group 2 had stable good control (HbA1c < 7% for at least 6 months) and served as a reference group for temporal stability. Total serum osteocalcin was measured at baseline (T0) and at 3 months (T3) and is reported in ng/mL. Body weight was retrieved retrospectively from the medical records. Analyses were exploratory.

Results

Sixty participants were included (mean age 52 +/- 9 years; 50% women). Baseline osteocalcin concentrations were similar in Group 1 and Group 2 (12.4 +/- 4.3 vs. 12.5 +/- 3.9 ng/mL; between-group mean difference − 0.1 ng/mL, 95% CI -2.2 to 2.0). In Group 1, osteocalcin increased from 12.4 +/- 4.3 to 20.4 +/- 4.8 ng/mL (absolute mean change + 8.0 ng/mL; p < 0.0001), whereas Group 2 remained stable (12.5 +/- 3.9 to 12.8 +/- 3.7 ng/mL; absolute mean change + 0.3 ng/mL; p = 0.94). At 3 months, Group 1 osteocalcin exceeded Group 2 by 7.6 ng/mL (95% CI 5.4 to 9.8). Overall body weight increased descriptively from 79 +/- 3 kg at baseline to 81 +/- 2.4 kg at 3 months.

Conclusions

Rapid improvement in glycaemic control was associated with increased circulating total osteocalcin over 3 months in chronically poorly controlled type 2 diabetes, while osteocalcin remained stable in a well-controlled reference group. Because the study was observational and important treatment, weight and lifestyle confounders were incompletely captured, the findings should be interpreted as hypothesis-generating rather than causal.

Trial registration

ClinicalTrials.gov NCT04893135; first posted 19 May 2021.