Relationships Between Serum Fetuin-A Levels And Bone Mineral Density, Glucose And Lipid Metabolism In Postmenopausal Women With Type 2 Diabetes

OBJECTIVE: To investigate the relationships between serum Fetuin-A levels with bone mineral density (BMD), glucose and lipid metabolism in postmenopausal women with type 2 diabetes mellitus.METHODS:49 postmenopausal women with type 2 diabetes were collected from Institute of Metabolism and Endocrinology in the Second Xiangya Hospital of Central South University from Oct 2008 to March 2010, and control group were 44 healthy postmenopausal women matched with age, body mass index and menopausal duration. The serum Fetuin-A were detected by Enzyme-linked immuno-sorbent assay (ELISA) methods; fasting plasma glucose and postprandial plasma glucose 2 hour (FPG,2hPG) were detected by glucose oxidase method; fasting C-peptide and postprandial C-peptide 2 hour (FCP,2h PCP) were detected by Chemiluminescence Immunoassay; glycosylated hemoglobin (HbA1c) were detected by ion-exchange high-performance liquid chromatography assay; HOMA-IR and HOMA%B were calculated using HOMA Calculator v2.2; BMD were measured at the posteroanterior lumbar spine (PAL 1-4), left femoral neck (FN), femoral shaft (Inter), trochanter (Troch) and total hip (Thip) by dual-energy x-ray absorptiometry (DXA).RESULTS:(1) Compared with the control group, serum levels of Fetuin-A in T2DM group were significantly lower (359.18±80.06 ug/ml,400.98±98.45 ug/ml, P<0.05), but there was no significant difference in HOMA-IR and BMD at PAL 1-4, FN, Inter, Troch and Thip. (2) In all postmenopausal women subjects, Multiple linear regression analysis showed triglyeride (TG),body mass index (BMI) and FPG were independant influencing factors of serum Fetuin-A(bj'=0.323,0.285,-0.349, P<0.05). (3) In healthy postmenopausal women subjects, Multiple linear regression analysis showed TG,BMI and HOMA-IR were independant influencing factors of serum Fetuin-A(b'j=0.297,0.216,-0.383, P<0.05).(4) In T2DM subjects, multiple linear regression analysis showed a positive correlation between Fetuin-A and TG and BMI (b'j=0.392,0.308, P<0.05), and a negative correlation between Fetuin-Aand HbA1c (b'j=-0.291, P<0.05). The regression formula was Fetuin-A(μg/ml)=201.046+23.672×TG+8.433×BMI—8.999×HbA1c.(5) All postmenopausal women subjects were divided into normal bone mass group, low bone mass group and osteoporosis(OP) group according to bone mass density(BMD), it was found that Fetuin-A had a declining tendency as decreasing of bone mass, but there was not statistically significant difference (P>0.05).CONCLUSIONS:(1) In postmenopausal women with type 2 diabetes, serum Fetuin-A was decreased, it may be correlated with high plasma glucose. (2) Fetuin-A in postmenopausal patients with OP were lower than who without osteoporosis, but serum Fetuin-A levels may not correlate with BMD directly.