| Objective:Diabetes mellitus and osteoporosis are diseases with anincreasing prevalence in the aging population and a substantial morbidity andmortality. The relationship between both medical conditions is complex andremains controversial, although it has been investigated extensively. Type2diabetes mellitus (T2DM) has been associated with an increased risk offractures at any skeletal site because of the poorer quality of the bone, evenwhen with greater bone mineral density (BMD). This association is due todetrimental effects of impaired glucose metabolism on bone health as well asto an increased risk of falls, frequently reported in diabetic patients. Moreover,some complications of diabetes may also contribute to fracture risk.Thediscovery of the Wnt signaling pathway and its relevance in bone homeostasishas contributed to a better knowledge of the cellular and molecularmechanisms of bone remodeling. The Wnt family includes more than15proteins that play an important role in organ development and in the regulationof various adult tissues such as bone. Activation of this pathway results in anexpansion of osteoprogenitor cells as well as reduced apoptosis of osteoblast,leading to anaboliceffects on bone. The binding of the Wnt ligands to acoerceptor complex composed of seven-transmembrane domain-spanningfrizzled receptor and low-density lipoprotein receptor-related protein (LRP)-5or-6stabilizes cytoplasmic β-catenin protein,which translocates into thenucleus and activates the transcription of target genes,namely Runx-2andosteoprotegerin. One of the major regulators of the Wnt pathway is theproduct of theSOSTgene, sclerostin, which is expressed almost exclusively inosteocytes. It is a secretedWnt antagonist that acts on bone mass bycompetitive binding to LRP-5.The role of the Wnt signaling pathway may becrucial in the pathogenesis of impaired bone quality observed in diabetes mellitus. Data regarding this pathway in diabetes mellitus are limited toanimal models and have focused on the analysis of gene expression orconcentration of the major proteins in the bone environment. However, to ourknowledge, no studies had been conducted in humans and more specifically inT2DM.In this context, the objectives of our study were to evaluate serumsclerostin and dkk1levels in T2DM patients and to analyze its relationshipswith bone BMD and related clinical factors,so that we can to provide certainbasis for the study of the relationship between T2DM and osteopsorosis,forclinical trials in the treatment of osteoporosis with DKK1, Sclerostinantibodies.Methods:A total of105T2DM inpatients were included in The ThirdHospital of Hebei Medical University Endocrinology Department from June2013to December2013. All subjects were measured BMD at L2-L4lumbarvertebrae, both femurs (neck, great trochanter, intertrochanter) by DEXA.According to the diagnostic criteria (DEXA) of the American association ofosteoporosis, the WHO, the European association of osteoporosis and bonedisease, all subjects were divided into normal group, bone bone loss groupand osteoporosis group. We record the gender, age, height, weight, durationand other related information of patients, calculate body mass index, andmeasure fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc),triglycerides (TG), cholesterol (TC), high-density lipoprotein (HDL-C), lowdensity lipoprotein (LDL-C) and other biochemical indicators, usingenzyme-linked immunosorbent method (enzyme-linked immunosorbentassay, ELISA) to evaluation serum sclerostin and DKK1level. All data wereshow by （x±SD）and were analyzed using SPSS13.0.Results:1The multiple regression analysis between BMD and age, gender, B-MI,glycosylated hemoglobin,duration:Age was negatively correlated withdouble hip and L2BMD,sex was negatively correlated with L3，Rneckbone density. 2There were no significant correlation between bone mineral density andage, gender, BMI, course, glycosylated hemoglobin, multiple of three groupsregression analysis.3DKK1and sclerostin level was statistically significant between threegroups (p <0.05).4The analysis of DKK1and sclerostin levels correlation with age, gender,course, glycosylated hemoglobin, bone mineral density in threegroups.Normal BMD group: DKK1and sclerostin levels were positivelycorrelated with course, glycosylated hemoglobin, There was no associatedwith age, sex. Osteopenia group: DKK1levels are positively related with age,glycosylated hemoglobin, and sclerostin level was positively related withduration, glycosylated hemoglobin concentration. Osteoporosis group: DKK1level was correlated with age, course, glycosylated hemoglobin, sclerostinlevels are positively related to glycosylated hemoglobin concentration.Conclusions:1The BMD of T2DM patients’ were influenced by age and sex, had nosignificant correlation with BMI, course, glycosylated hemoglobin2DKK1and sclerostin level was influenced by age, course, glycosylatedhemoglobin concentration and BMD of patients. |
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