The Difference of Bone Turnover Marker between Diabetes and Non-diabetes Osteoporotic Hip Fracture Patient


  • Pariwat Patphai Lerdsin Hospital
  • Thitinun Anusornvongchai Lerdsin Hospital


Bone remodeling, fragility hip fracture, Diabetes mellitus, Procollagen type 1 amino-terminal propeptide (P1NP), C-terminal of collagen (CTX)


Background: Abnormal bone remodeling process (formation and resorption) results in osteoporosis, weakens bones and increases risk of fracture. Many medical diseases are associated with abnormal bone remodeling, such as chronic kidney disease, liver disease, cancer, and diabetes mellitus. Currently, laboratory evaluation of bone formation and bone resorption markers are available. Objective: To study the difference between these bone turnover markers in patients with fragility hip fracture who have diabetes mellitus, compared to non-diabetic patients. Methods: We conducted an analytical cross-sectional study in patients age 50 years or older who presented with fragility hip fracture and were admitted in Lerdsin Hospital from 1 February 2021 to 31 January 2022. Baseline demographic data, basic laboratory results (hemoglobin A1c, calcium, phosphate, vitamin D), bone formation marker (Procollagen type 1 amino-terminal propeptide; P1NP) levels, and bone resorption marker (C-terminal of collagen; CTX) levels were collected and further statistically analyzed with SPSS program. Result: A total of 109 patients were included in this study. There were 52 patients with diabetes (47.71%) and 57 non-diabetic patients (52.29%). The mean P1NP levels were 63.93 ng/mL in diabetes group and 53.24 ng/mL in non-diabetes (p-value = .483). The mean CTX levels were not significantly different between diabetic and non-diabetic patients, measuring 0.54 and 0.57 ng/mL, respectively (p-value = .326). However, diabetic patients tended to have a lower age at index fracture event, with a mean of 74.94 years, compared to 77.25 years in non-diabetic patients (p-value = .130). Conclusion: There was no statistically significant difference between serum levels of bone turnover markers, measured as P1NP for bone formation and CTX as bone resorption biomarkers, between diabetic and non-diabetic patients who had fragility hip fracture.


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How to Cite

Patphai P, Anusornvongchai T. The Difference of Bone Turnover Marker between Diabetes and Non-diabetes Osteoporotic Hip Fracture Patient. J DMS [Internet]. 2023 Dec. 15 [cited 2024 Apr. 15];48(4):108-15. Available from:



Original Article