The Relationship Of BMD And Markers Of Bone Turnover With Fetuin-a In Elderly Type 2 Diabetic Subjects

Objective:To evaluate the relationship of plasma fetuin-A levels with BMD and markers of bone turnover in elderly type 2 diabetic subjects.Methods:This is a Cross-sectional study that 103 patients with type 2 diabetes [48 men and 55 women] were studied. Levels of fetuin-A were determined in all samples using commercially available sandwich enzyme linked immunosorbent assay. BMD of the lumbar spine at L2-4 and at the femur was measured using DXA. The levels of bone turnover biomarkers,serum sex hormone and other clinical indexes were detected. Partial correlation analysis was used to assess the relationship between serum fetuin-A and clinical indexes.Results:There is no difference in serum fetuin-A between male and female. Among men, fetuin-A had significant negative associations with serum β-CTX (r=-0.307, P=0.024,95% CI:-0.620,0.077), but fetuin-A had no relationship with BMD. Among women,serum fetuin-A was negatively correlated with the femoral neck BMD (r=-0.336, P=0.020,95% CI-0.563,-0.084), but not correlated with bone mineral density of the lumbar spine. In a model adjusted for age, BMI, time since diagnosis of diabetes, presence of micro-, cardio-, and peripheral vascular diabetic complications, C-pepetide, HOMA-IR, CRP, PTH, HbA1c, eGFR, Fatty liver, E2, FTI and SHBG, the relationship between serum fetuin-A and β-CTX still exist (r=-0.348, P=0.047) in men. In women, however there was no correlation between serum fetuin-A and femoral neck bone density(r=-0.279, P=0.152). According to our study, no correlations were found between the levels of serum fetuin-A and E2, T, FTI and SHBG in elderly men.Conclusions:Results suggest that serum fetuin-A had promoting physiological mineralization in bone low conversion condition.