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Bone mineral density and markers of bone turnover and inflammation in diabetes patients with or without a Charcot foot: An 8.5-year prospective case-control study

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  • Rasmus Bo Jansen
  • Tomas Møller Christensen
  • Jens Bülow
  • Lene Rørdam
  • Per E. Holstein
  • Niklas Rye Jørgensen
  • Ole Lander Svendsen
Vis graf over relationer

Background and aims Charcot foot is a rare but severe complication to diabetes and peripheral neuropathy. It is still unclear if an acute Charcot foot has long-term effects on the bone metabolism. To investigate this, we conducted a follow-up study to examine if a previously acute Charcot foot has any long-term effects on bone mineral density (BMD) or local or systemic bone metabolism. Methods An 8.5-year follow-up case–control study of 44 individuals with diabetes mellitus, 24 of whom also had acute or chronic Charcot foot at the baseline visit in 2005–2007, who were followed up in 2015 with DXA scans and blood samples. Results 21 of the 44 baseline participants participated in the follow-up. There were no difference in the change in total hip BMD from baseline to follow-up in either the Charcot or the control group (p = 0.402 and 0.517), and no increased risk of osteoporosis in the previous Charcot feet either. From baseline to follow-up, there was a significant difference in the change in levels of fsRANK-L in the Charcot group, but not in the control group (p = 0.002 and 0.232, respectively). At follow-up, there were no differences in fsRANK-L between the groups. The fsRANK-L/OPG ratio also significantly decreased from baseline to follow-up in the Charcot group (3.4 versus 0.5) (p = 0.009), but not in the control group (1.3 versus 1.1) (p = 0.302). Conclusion We found that diabetes patients with an acute Charcot foot have an elevated fsRANK-L/OPG ratio, and that the level decreased from baseline to follow-up to be comparable to the level in diabetes patients without previous or current Charcot foot. We found no permanent effect of an acute Charcot foot on hip or foot BMD.

OriginalsprogEngelsk
TidsskriftJournal of Diabetes and its Complications
Vol/bind32
Udgave nummer2
Sider (fra-til)164-170
Antal sider7
ISSN1056-8727
DOI
StatusUdgivet - 1 feb. 2018

ID: 52621949