{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:37:06Z","timestamp":1776893826255,"version":"3.51.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Diabetic kidney disease (DKD) is one of the most serious complications of type 2 diabetes mellitus (T2DM), and bone metabolism disorders show a close linkage to DKD. Thus, this study aimed to explore the association between bone turnover markers (BTMs) and DKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In present cross-sectional study, serum BTMs were detected in 1433 hospitalized patients with T2DM. Logistic regression analysis was used to investigate the associations between osteocalcin (N-MID), \u03b2-cross-linked C-telopeptide (\u03b2-CTX), total type I collagen N-terminal propeptide (PINP), and the risk of DKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The circulation N-MID, \u03b2-CTX, and PINP levels were significantly lower in the DKD group compared with the non-DKD group (all P &amp;lt; 0.05), especially in male and aged &amp;lt; 60 subgroups. Serum BTM levels showed a weak correlations with certain glucose metabolism parameters\u2013such as glycated hemoglobin, fasting blood glucose, C peptide, and fasting insulin\u2212as well as alkaline phosphatase (ALP) levels and low-density lipoprotein (all P &amp;lt; 0.001). A weak negative correlation was also observed with the duration of diabetes (all P &amp;lt; 0.0001). In addition, \u03b2-CTX levels showed a minimal positive correlation with eGFR (r = 0.057, P=0.036) and a modest correlation with ALP (r = 0.31, P &amp;lt; 0.0001). After adjusting for potential confounders, higher serum \u03b2-CTX levels were independently associated with a lower risk of DKD. However, no significant associations were found among serum N-MID, PINP, and the risk of DKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BTM levels were significantly decreased in patients with DKD. Lower \u03b2-CTX levels were independently associated with a larger prevalence of DKD after adjusting for potential confounders, suggesting that serum \u03b2-CTX may be an independent marker associated with the risk of DKD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1646690","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:13:52Z","timestamp":1759205632000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Relationship between bone turnover markers and diabetic kidney disease in patients with type 2 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