Study On The Levels Of Serum 25(OH)D、Irisin In Patients With Type 2 Diabetes With Different Bone Mass

Objective: To determine the levels of serum 25-hydroxyvitamin D and Irisin in patients with type 2 diabetes mellitus with different bone mass,to analyze the correlations between25(OH)D、Irisin and the other clinical indices,to explore the possible roles of 25(OH)D and Irisin in the development of osteoporosis in type 2 diabetes mellitus.Methods: A total of 152 type 2 diabetic patients(T2DM)who were treated in the Affiliated Hospital of Zunyi Medical College were selected in this study.All patients were measured bone mineral density by Dual energy X-ray absorptiometry(DEXA)and osteoporosis diagnosis criteria.According to the WHO diagnostic criteria of osteoporosis,all the T2 DM patients were divided into normal bone mass group(A group,N=55),osteopenia group(B group,N=48),osteoporosis group(C group,N=49)physical.Another50 healthy subjects with age and gender matched were enrolled as normal control group(NCgroup,N=50),and which confirmed that the bone mass were normal.The sex,age,course of diabetes,height and body mass of all the subjects were recorded.The serum levels of fasting blood glucose(FBG),fasting insulin(FINS),glycosylated hemoglobin(Hb A1c),cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were measured in all the subjects,BMI,homeostasis model insulin resistance index(HOMA-IR)were calculated.And the serum Irisin level was measured by Enzyme-linked immunosorbent assay(ELISA).The levels of serum 25(OH)D,Irisin and all the clinical indexes were compared.Results: 1.(1)Compared with NC group,the levels of BMI,Hb A1 c,FPG,ln(HOMA-IR),LDL-C and TC in A,B and C group were significantly higher,and the levels of the HDL-C in A,B and C group were significantly lower,the levels of BMD(L1-4),BMD(Neck)in B and C group were significantly lower(P < 0.05).(2)Compared with A group,the levels of Hb A1 c in B,C group and the levels of the course of disease,ln(HOMA-IR),TC,LDL-C in C group were significantly higher,the levels of BMD(L1-4),BMD(Neck)in B,C group were significantly lower(P < 0.05).(3)Compared with B group,the levels of the course of disease,Hb A1 c,ln(HOMA-IR),TC and LDL-C in C group were significantly higher,and the level of BMD(Neck)was significantly lower(P < 0.05).2.The levels of serum25(OH)D and Irisin in the four groups were statistically significant(P < 0.05).The levels of Irisin in NC,A,B and C groups decreased gradually among every group(P < 0.05);The level of 25(OH)D in the C group was significantly lower than that in NC group,A group and B group(P < 0.05);The levels of 25(OH)D in A group,B group were significantly lower than NC group(P < 0.05).3.The level of 25(OH)D was negatively with the course of disease,Hb A1 c,TC,LDL-C,and was positively correlated with BMD(Neck,L1-4)and Irisin(P < 0.05);The level of Irisin was negatively with Hb A1 c,ln(HOMA-IR),was positively correlated with BMD(Neck)and 25(OH)D(P < 0.05).4.Logistic regression analysis showed that Hb A1 c,LDL-C,25(OH)D and Irisin were risk factors for osteoporosis in T2 DM patients.Conclusion: The levels of serum 25(OH)D and Irisin in T2 DM patients were significantly lower than those in the normal population;The levels of serum Irisin decreased gradually among the normal bone mass group,osteopenia group,osteoporosis in group T2 DM patients.Low levels of 25(OH)D,Irisin may be involved with the development of osteoporosis in T2 DM patients.