The Positive Association of Plasma Levels of Vitamin C and Inverse Association of VCAM-1 and Total Adiponectin with Bone Mineral Density in Subjects with Diabetes

Abstract

Context. Population studies have shown a trend in decreasing vitamin C status and increasing prevalence of osteoporosis in patients with diabetes and non-diabetic people. Dietary vitamin C consumption is linked to improvement in bone mineral density (BMD) in epidemiological studies. VCAM-1 and adiponectin are known to activate osteoclasts, which increase bone loss. Aim: This study examined whether there is any association between the circulating level of vitamin C and BMD and whether the beneficial effect of vitamin C on BMD was linked to a simultaneous decrease in circulating levels of adiponectin and VCAM-1 in subjects with diabetes. Methods: Patients with diabetes (T2D, n = 74) and age-matched non-diabetic controls (n = 26) were enrolled in this study. Fasting blood levels of glycemia, adiponectin, VCAM-1, inflammation biomarkers, and vitamin C were determined in both groups. The BMD of the lumbar spine (L1–L4), left femur, and right femur was determined using a DXA scan in subjects with diabetes. Results: Patients with diabetes had lower levels of vitamin C and higher levels of VCAM-1 and inflammatory cytokines. There was a significant positive association between vitamin C blood levels and lumbar spine BMD as well as a significant negative association between total adiponectin and VCAM-1 levels with that of vitamin C and lumbar BMD in patients with diabetes. Total adiponectin and VCAM-1 also showed a negative association with BMD of both the right and left femurs. The inter-relationship among the circulating levels of vitamin C and VCAM-1 and BMD was strong and is a novel finding. Conclusions: This study reports a positive association of circulating vitamin C levels and the BMD and that the beneficial effects of vitamin C on BMD could be linked to a simultaneous lowering in circulating VCAM-1 and total adiponectin levels. Thus, dietary vitamin C consumption has potential to lower inflammation and the risk of osteoporosis in subjects with diabetes.