Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus
IntroductionType 2 diabetes mellitus (T2DM) is often accompanied by bone metabolic disorders and cognitive impairment, forming an interactive network through metabolic derangements, oxidative stress, and inflammatory responses. Hyperglycemia and insulin resistance disrupt bone remodeling leading to...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1530462/full |
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| author | Jiang Li Jiang Li Yuxiao An Jian Qin Jian Qin Noor Shafini Mohamad Izzad Ramli |
| author_facet | Jiang Li Jiang Li Yuxiao An Jian Qin Jian Qin Noor Shafini Mohamad Izzad Ramli |
| author_sort | Jiang Li |
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| description | IntroductionType 2 diabetes mellitus (T2DM) is often accompanied by bone metabolic disorders and cognitive impairment, forming an interactive network through metabolic derangements, oxidative stress, and inflammatory responses. Hyperglycemia and insulin resistance disrupt bone remodeling leading to osteoporosis while simultaneously impairing cognition via blood-brain barrier damage and neuroinflammation. Osteogenic factors like osteocalcin may bidirectionally regulate glucose metabolism and brain function, suggesting that “bone-brain axis” dysregulation could be a potential mechanism underlying cognitive impairment in T2DM. This study aims to characterize cognitive function patterns in T2DM patients with bone metabolic abnormalities and their clinical correlations, providing a basis for multisystemic interventions.MethodsThe general clinical data, osteocalcin (OC), glycosylated hemoglobin (HbA1c), bone mineral density (BMD), and the Montreal Cognitive Assessment (MoCA) scores of 50 patients with T2DM were collected. According to whether cognitive impairment occurred or not, one-way ANOVA was performed to analyze the correlation between cognitive and clinical indicators, BMD and OC. Multiple linear regression analysis was performed with cognition and bone density as dependent variables and other factors as independent variables.ResultsT2DM subjects were grouped according to bone mass. The osteoporosis group had the lowest MoCA score and bone density, followed by the osteopenia group. There were 16 cases (16/17 94.12%) of cognitive impairment in the osteoporosis group, 13 cases (13/17 76.47%) of cognitive impairment in the osteopenia group, and 3 cases (3/16 18.75%) of cognitive impairment in the normal bone mass group. Compared with the normal cognitive group, the MoCA score, OC measurement and BMD of the patients in the cognitive impairment group were lower (P < 0.05). BMD (r = 0.686, P = 0.000), OC (r = 0.756, P = 0.000) are positively correlated with MoCA score. OC (r = 0.690, P = 0.000) and Age (r = −0.032, P = 0.045) are positively correlated with BMD. Multivariate linear regression analysis found that with cognition as the dependent variable, the decrease in BMD (P = 0.028) and OC (P = 0.000) aggravated the occurrence of cognitive impairment; with BMD as the dependent variable, the decline in cognition (P = 0.028) and OC (P = 0.029) aggravated the decrease in BMD.ConclusionT2DM, osteoporosis, and cognitive impairment form pathological connections through metabolic disorders, chronic inflammation, and bidirectional regulatory networks of the “bone-brain axis,” with osteocalcin serving as a key mediator that maintains bone remodeling balance while also exerting cross-domain regulation over central insulin signaling and synaptic plasticity. Understanding these interactive mechanisms provides a basis for developing combined screening models integrating bone density and cognitive assessments, and promotes multidisciplinary collaborative interventions across endocrinology, orthopedics, and neurology to improve overall outcomes for T2DM patients. |
| format | Article |
| id | doaj-art-8562789d531b4be4b3db0584f41f5f66 |
| institution | DOAJ |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-8562789d531b4be4b3db0584f41f5f662025-08-20T02:56:09ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15304621530462Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitusJiang Li0Jiang Li1Yuxiao An2Jian Qin3Jian Qin4Noor Shafini Mohamad5Izzad Ramli6Faculty of Health Sciences, Universiti Teknologi MARA, Shah Alam, MalaysiaThe Second Affiliated Hospital of Shandong First Medical University, Taian, ChinaThe Second Affiliated Hospital of Shandong First Medical University, Taian, ChinaFaculty of Health Sciences, Universiti Teknologi MARA, Shah Alam, MalaysiaThe Second Affiliated Hospital of Shandong First Medical University, Taian, ChinaMedical Imaging, Faculty of Health and Life Sciences, Exeter, United KingdomCollege of Computing, Informatics and Mathematics, Universiti Teknologi MARA, Shah Alam, MalaysiaIntroductionType 2 diabetes mellitus (T2DM) is often accompanied by bone metabolic disorders and cognitive impairment, forming an interactive network through metabolic derangements, oxidative stress, and inflammatory responses. Hyperglycemia and insulin resistance disrupt bone remodeling leading to osteoporosis while simultaneously impairing cognition via blood-brain barrier damage and neuroinflammation. Osteogenic factors like osteocalcin may bidirectionally regulate glucose metabolism and brain function, suggesting that “bone-brain axis” dysregulation could be a potential mechanism underlying cognitive impairment in T2DM. This study aims to characterize cognitive function patterns in T2DM patients with bone metabolic abnormalities and their clinical correlations, providing a basis for multisystemic interventions.MethodsThe general clinical data, osteocalcin (OC), glycosylated hemoglobin (HbA1c), bone mineral density (BMD), and the Montreal Cognitive Assessment (MoCA) scores of 50 patients with T2DM were collected. According to whether cognitive impairment occurred or not, one-way ANOVA was performed to analyze the correlation between cognitive and clinical indicators, BMD and OC. Multiple linear regression analysis was performed with cognition and bone density as dependent variables and other factors as independent variables.ResultsT2DM subjects were grouped according to bone mass. The osteoporosis group had the lowest MoCA score and bone density, followed by the osteopenia group. There were 16 cases (16/17 94.12%) of cognitive impairment in the osteoporosis group, 13 cases (13/17 76.47%) of cognitive impairment in the osteopenia group, and 3 cases (3/16 18.75%) of cognitive impairment in the normal bone mass group. Compared with the normal cognitive group, the MoCA score, OC measurement and BMD of the patients in the cognitive impairment group were lower (P < 0.05). BMD (r = 0.686, P = 0.000), OC (r = 0.756, P = 0.000) are positively correlated with MoCA score. OC (r = 0.690, P = 0.000) and Age (r = −0.032, P = 0.045) are positively correlated with BMD. Multivariate linear regression analysis found that with cognition as the dependent variable, the decrease in BMD (P = 0.028) and OC (P = 0.000) aggravated the occurrence of cognitive impairment; with BMD as the dependent variable, the decline in cognition (P = 0.028) and OC (P = 0.029) aggravated the decrease in BMD.ConclusionT2DM, osteoporosis, and cognitive impairment form pathological connections through metabolic disorders, chronic inflammation, and bidirectional regulatory networks of the “bone-brain axis,” with osteocalcin serving as a key mediator that maintains bone remodeling balance while also exerting cross-domain regulation over central insulin signaling and synaptic plasticity. Understanding these interactive mechanisms provides a basis for developing combined screening models integrating bone density and cognitive assessments, and promotes multidisciplinary collaborative interventions across endocrinology, orthopedics, and neurology to improve overall outcomes for T2DM patients.https://www.frontiersin.org/articles/10.3389/fmed.2025.1530462/fulltype 2 diabetes mellitusabnormal bone metabolismcognitive impairmentbone mineral densityosteocalcin |
| spellingShingle | Jiang Li Jiang Li Yuxiao An Jian Qin Jian Qin Noor Shafini Mohamad Izzad Ramli Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus Frontiers in Medicine type 2 diabetes mellitus abnormal bone metabolism cognitive impairment bone mineral density osteocalcin |
| title | Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| title_full | Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| title_fullStr | Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| title_full_unstemmed | Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| title_short | Study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| title_sort | study on the correlation between abnormal bone metabolism and cognitive impairment in type 2 diabetes mellitus |
| topic | type 2 diabetes mellitus abnormal bone metabolism cognitive impairment bone mineral density osteocalcin |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1530462/full |
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