Clinical Study On Effects To Chemerin And Lipid Metabolism By Using Zoledronic Acid In Patients With Osteoporosis

Objective:To explore the change of the serum Chemerin concentration and its possible effcct on osteoporosis by detecting the levels of Chemerin,t P1 NP,?-Cross Laps,N-MID, Ca, P,TC,TG,HDL,LDL,AOPA,APOB,APOE,LPa and analyzing the relationship between Chemerin and lipid metabolism in osteoporosis with zoledronic acid.Methods:Based on the radom sampling method,31 cases of patients with osteoporosis who sought treatment between January 2014 and December 2015 in the endocrinology department of our hospital were selected,wherein 4 are males and 27 are females.These cases were across an age range from 47 to 86,with a median age of 66.9±10.According to WHO classification of osteoporosis by the T/Z scores of BMD(in postmenopausal women with T score, premenopausal women with Z score).According to WHO classification of osteoporosis by the T/Z scores of BMD(in postmenopausal women with T score,premenopausal women with Z score),T/Z≤- 2.5 were diagnosed with osteoporosis. All patients had bisphosphonate intravenous therapy and oral basic medicine( calcium 600 mg/ d, calcitriol 0. 25 ug /d).There were 21 cases of patients treated with cycle for 1-2 years, a retrospective analysis of 21 cases of patients with bisphosphonates therapy for long-term observation of related index, including the 1 year treatment group(21 cases) and 2 years treatment group(8 cases).Height, weight of all subjects were measured and body mass index was calculated. BMI, age and all of subjects were record carefully. Using ELISA method to measure the levels of Chemerin,using ECLI method to detect the levels of N-MID OCN, t P1 NP, β-Crosslaps,Automatic biochemical analyzer detection of blood Ca,P, TC, TG, HDL, LDL,APOA,APOB,APOE,LPa levels.Using dual-energy X-rayIV absorptiometry to measure bone mineral density of the lumbar spine(L1-4) and femoral Neck(Neck) and a third of the forearm of all patients on the date of blood(DXA)determination.Compare the difference of index between each groups. And analyzed the relationship between Chemerin and blood lipid levels,bone mineral density in diagnosed op disease patients.Results:1.Compare the after treatment group of OP patients with before.There was no statistic difference in age, BMI(p > 0.05); The level of Chemerin reduced,the difference was statistically significant(P < 0.01);The level of t P1 NP,β-Cross Laps and N-MID OCN reduced,the difference was statistically significant(P < 0.05);TC,TG,LDL deceased,HDL increased,he difference was statistically significant(P < 0.05,P < 0.01);there were no differences in Ca,P.2.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, the difference was statistically significant(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,the difference was statistically significant(P < 0.05,P<0.01); 2 years treatment group,there were no differences of the BMD at L1-4, neck and distal radius 1/3.3.In OP patients,the correlation analysis showed that Chemerin positively correlated with BMI,(r=0.573,P<0.05)significantly positive correlation with TC 、 TG 、LDL,(r=0.837,r=0.529,r=0.689,P<0.05),significantly negative correlation with HDL,(r=-0.75);and positively correlated with N-MID OCN 、 t TPINP,(r=0.692,r=0.653,P<0.05).Conclusion:1. After bisphosphonate intravenous therapy, chemerin decreased than before, and positively correlalated with the change of TC,TG,LDL, APOB,APOE positively correlalated with the change of HDL,APOA, suggests that bisphosphonate anti osteoporosis treatment may through affecting the level of Chemerin, thereby affecting the lipid metabolism regulation.2. 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.