Research On The Relationship Between Glucose Metabolism And Bone Metabolism In Diabetic Patients

Objective(Part 1) To investigate the change of glucose metabolic indices such as fasting insulin, C-peptide, HOMA-IR and bone metabolic indices such as N-MID OC, PINP, β-CTX, 25-(OH)D3, PTH in gestational diabetes mellitus patients, and further analyse the correlation between them.(Part 2) To investigate the change of glucose metabolic indices such as fasting plasma glucose, Hb A1 C and bone metabolic indices such as N-MID OC, PINP, β-CTX in older women with type 2 diabetes, and further analyse the correlation between them.Methods(Part 1) 50 Gestational diabetes mellitus patients(GDM group) and 50 pregnant women with normal glucose tolerance(NGT group) were included in this study. The levels of serum fasting insulin, C-peptide, N-MID OC, PINP, β-CTX, 25-(OH)D3 and PTH were detected. We calculated HOMA-IR, compared glucose metabolic indices and bone metabolic indices in two groups and then made statistical analysis.(Part 2) 46 over 60 years old female patients with type 2 diabetes(diabetes group) and 31 women with normal glucose tolerance(control group) were included in this study. The levels of serum fasting plasma glucose, Hb A1 C, N-MID OC, PINP and β-CTX, were detected. We compared glucose metabolic indices and bone metabolic indices in two groups and then made statistical analysis.Results(Part 1) The levels of glucose metabolic indices such as serum fasting insulin, C-peptide and HOMA-IR in GDM group were significantly higher than those in NGT group(P=0.015, P=0.003 and P=0.005, respectively), and bone metabolic indices such as N-MID OC, PINP and β-CTX in GDM group were significantly higher than those in NGT group(P=0.005, P=0.018 and P=0.038, respectively), but there was no significant difference in the levels of 25-(OH)D3 and PTH between two groups. Correlation analysis showed that N-MID OC correlated with C peptide, fasting insulin and HOMA-IR(R=0.348, 0.400, and 0.332, respectively), and PINP correlated with C peptide, fasting insulin and HOMA-IR(R=0.435, 0.540, and 0.480, respectively), and β-CTX correlated with C peptide, fasting insulin and HOMA-IR(R=0.202, 0.253, and 0.219, respectively).(Part 2) The levels of glucose metabolic indices such as serum fasting plasma glucose, Hb A1 C in diabetes group were significantly higher than those in control group(P<0.001), and bone metabolic indices such as N-MID OC, PINP, β-CTX in diabetes group were significantly lower than those in control group(P<0.001). Correlation analysis showed that fasting plasma glucose correlated with N-MID OC, PINP and β-CTX(R=-0.455,-0.326 and-0.335, respectively), and Hb A1 C correlated with N-MID OC, PINP and β-CTX(R=-0.556,-0.411 and-0.378, respectively).Conclusions(Part 1) In gestational diabetes mellitus patients, glucose metabolism shows higher levels of fasting insulin, C-peptide and HOMA-IR, and bone metabolism shows higher levels of N-MID OC, PINP and β-CTX. Meanwhile, there is obvious positive correlation between fasting insulin, C-peptide, HOMA-IR and N-MID OC, PINP, β-CTX.(Part 2) In older women with type 2 diabetes, glucose metabolism shows higher levels of fasting plasma glucose, Hb A1 C, and bone metabolism shows lower levels of N-MID OC, PINP and β-CTX. Meanwhile, there is obvious negative correlation between fasting plasma glucose, Hb A1 C and N-MID OC, PINP, β-CTX.