| Objective:Select primary osteoporosis patients which were treated by zoledronic acid as our research objects, by detecting the levels of BMP-9, FINS, FCP, FPG, Hb A1 c, t P1 NP,β-Cross Laps, N-MID osteocalcin, Ca, P, TC,TG,HDL, LDL and calculating the function of islet function, each index before and after treatment were compared, through bisphosphonate therapy for short-term and long-term observation to discuss effects on BMP-9 and islet function by bisphosphonate treatment in patients.Methods:From January 2014 to January 2016, 31 patients were enrolled in this study which were diagnosed primary osteoporosis in Endocrinology Department of our hospital. The study participants consisted of 4 males and 27 females aged between 47 and 86 years. All patients match the diagnostic criteria of WHO classification of osteoporosis. All patients had bisphosphonate intravenous therapy and oral basic medicine( calcium 600 mg / d,calcitriol 0. 25 ug /d).The duration of treatment was different in this patients, treatment cycle of 21 patients was 1-2 years. A retrospective analysis of 21 patients was performed which were treated by bisphosphonates for long-term observation, including the 1 year treatment group(21 cases) and 2 years treatment group(8 cases).All cases were measured height, weight, body mass index.The serum level of BMP-9 were measured using ELISA.The serum level of Hb A1 c were measured using HPLC.The serum level ofβ-Cross Laps, N-MID OCN,t P1 NP were measured using ECL.The serum level of FINS,FCP were measured using Chemiluminescence method.The blood Ca, P, FPG, TC, TG,HDL, LDL levels were detecting by using Automatic biochemical analyzer. HOMA-IS,HOMA-IAI and HOMA-IR were calculated according to the levels of FINS and FPG.Bone mass of the patients were detected using duel-energy X-ray absorptiometry.To analyze the relationship between BMP-9 and FPG, FINS, FCP,insulin secretion index and bone markers by comparing the differences of BMP-9 levels and other indicators after bisphosphonate therapy.Results:1. Regardless of the duration of treatment, after bisphosphonate intravenous therapy,bone resorption index β-Crosslaps decreased significantly, the bone formation index t PINP, N-MID OCN decreased(P < 0.05,P < 0.01); long-term observation of bisphosphonate intravenous therapy, compared with before treatment,1 year treatment group L1-4 BMD and Neck BMD were increased(P < 0.05,P<0.01); 2 years treatment group,there were no differences of the BMD at L1-4, neck and distal radius 1/3.2.In short-term observation group,after treatment were observed in intravenous bisphosphonates, BMP-9 decreased(P < 0.05); FINS and FCP decreased(P < 0.05, P <0.01); HOMA-IAI decreased(P < 0.05); HOMA-IS decreased,HOMA-IR increased,the difference was not statistically significant;in long-term observation group, in 1 year treatment group Hb A1 c increased(P < 0.01); FPG increased,FCP decreased(P <0.05);FINS decreased, the difference was not statistically significant; In the long-term observation group, compared with before treatment, HOMA-IS decreased, HOMA-IR increased, HOMA-IAI decreased, the difference was not statistically significant.3.In short-term observation group,TC, TG, LDL levels decreased, HDL levels increased(P < 0.05, P < 0.01); the serum levels of Ca and P had no significant changes;in long-term observation group, TC, TG, LDL levels decreased, HDL levels increased, the difference was not statistically significant;the serum levels of Ca and P had no significant changes.4.In short-term observation group, the correlation analysis showed that the change of BMP-9 positively correlalated with the change of FINS and FCP(r=0.528,r=0.559;P<0.05), positively correlated with the change of HOMA-IAI and HOMA-IS(r=0.456,r=0.381; P<0.05), no correlation with the change of FGP and HOMA-IR,positively correlalated with the change of N-MIDOCN and t PINP(r=0.685,r=0.385;P<0.05),no correlation with the change of β-Crosslaps.Conclusions:1. After bisphosphonate intravenous therapy, bone absorption index decreased significantly, bone formation markers decreased, bone density increased, indicating that bisphosphonates inhibit osteoclast activity, inhibit bone resorption. Long-term bisphosphonates treatment can increase bone density and has significant anti osteoporosis effect.2. After bisphosphonate intravenous therapy, BMP-9 decreased than before, and positively correlalated with the change of FINS and FCP, positively correlalated with the change of HOMA-IAI and HOMA-IS, suggests that bisphosphonate anti osteoporosis treatment may through affecting the level of BMP9, thus affecting insulin levels, thereby affecting the blood glucose regulation. |
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