Comparison Of Serum 25(OH)D And BMP-2 Levels In Elderly Patients With Type 2 Diabetes Mellitus Complicated With Sarcopenia Under Different Bone Mass

Objective: To compare the difference in the levels of serum bone morphogenetic protein-2(BMP-2),25-hydroxy vitamin D(25(OH)D)in elderly patients with type 2 diabetes mellitus(T2DM)complicated with sarcopenia(SP)under different bone mass.The aim is to investigate the correlation between BMP-2and 25(OH)D on muscle mass and bone mass in hyperglycemic state,and provide new targets for prevention and treatment of type 2 diabetes mellitus combined with sarcopenia and osteoporosis.Methods: A total of 120 outpatients and inpatients in the Hospital were included(all patients with diabetes were newly diagnosed with T2DM),the groups divided as follows: 30 patients(14 males and 16 females)in the elderly simple Diabetes group(Diabetes Mellitus,DM),90 elderly patients with type 2 diabetes combined with sarcopenia(46 males and 44 females)were divided into 3 groups according to their bone mass.30 cases(male 15,female 15)were normal bone mass group,and 30 cases(male 14,female 16 case)of osteopenia group.There were 30 cases in osteoporosis group(17 males and 13 females).During the same period,30 Normal subjects(15males and 15 females)in Normal Control group were randomly selected from the physical examination center of our hospital.25(OH)D was detected by chemiluminescence,the content of serum BMP-2 was detected by enzyme-linked immunosorbent assay(ELISA).Statistical software package for statistical analysis,partial correlation analysis is used for the correlation of different variables,and logistic regression analysis is used for the influencing factors of T2 DM combined with SP and op.P < 0.05 is the difference with statistical significance.Results:(1)Compared with NC group,the levels of BMI,FPG,FINS,HOMA-IR,Hb A1 c,TG,LDL-C and TC in other four groups were increased(P < 0.05),25(OH)D,BMP-2,SMI levels decreased(P < 0.05),the level of HDL-C in normal bone mass group,decreased bone mass group and OP group decreased(P < 0.05),the ALP level was higher in decreased bone mass group and OP group(P < 0.05);(2)Compared with DM group,BMI,FPG,Hb A1 c,TG,TC,LDL-C and HOMA-IR levels in normal bone mass group,decreased bone mass group and OP group were higher(P < 0.05),the levels of HDL-C,25(OH)D,BMP-2 and SMI decreased(P < 0.05),ALP level increased in decreased bone mass group and OP group(P < 0.05);(3)Compared with normal bone mass group,ALP level in decreased bone mass group was higher(P <0.05),25(OH)D,BMP-2,SMI levels decreased(P < 0.05),the levels of BMI,25(OH)D,BMP-2 and SMI in OP group were decreased(P < 0.05),while TG and ALP were increased(P < 0.05);(4)Compared with decreased bone mass group,TG level in OP group increased(P < 0.05),BMI and BMP-2 levels decreased(P < 0.05).Partial correlation analysis showed that serum BMP-2 level was positively correlated with HDL-C and 25(OH)D,and negatively correlated with HOMA-IR,FPG,Hb A1 C and TG.logistic regression analysis showed that TG,FPG,Hb Alc and HOMA-IR were risk factors for T2 DM combined with SP and OP,while 25(OH)D and BMP-2were protective factors for T2 DM combined with SP and OP.Conclusion: The decrease of serum BMP-2 and 25(OH)D levels may be a risk factor for bone loss and SP in elderly T2 DM patients.Positive improvement of glucose and lipid metabolism disorders,IR and increase of serum BMP-2 and 25(OH)D levels have positive effects on the prevention and treatment of T2 DM,OP and SP in the elderly population,and the specific mechanism needs further study to verify.