The Effect Of Serum Level Of SFRP5 On Bone Mineral Density In Type 2 Diabetes Mellitus Patients With Osteoporosis

Objective:With the increasing trend of society and the extension of average life expecta, diabetes and osteoporosis has become a worldwide common disease, associated with substantial morbidity and mortality. Diabetes can affect bone turnover and bone integrity through a variety of ways, and diabetes and its related complications can greatly increase the risk of falls, which will further promote fractures.Diabetic bone disease belonging to a complication of diabetes is often overlooked.Recent studies show that Wnt/β-catenin signaling pathway plays an important role in the growth and development of bone tissue as well as the balance of bone metabolism. Wnt/β-catenin signaling pathway can regulate osteoblast differentiation and bone matrix formation. The binding of the Wnt ligands 、frizzled receptor and low-density lipoprotein receptor-related protein(LRP)-5 or-6 can activate the pathway. The activation of Wnt signaling pathway can promote the proliferation of bone progenitor cells, benefit to bone formation. Secreted frizzled related protein 5(SFRP5) can compete with Wnt5 a protein, inhibit the binding of Wnt ligands and frizzled, block the signal transduction and influence bone formation. At present, the research of SFRP5 has become a hot spot in the prevention and treatment of osteoporosis.SFRP5 is a novel anti-inflammatory adipocyte factor, which is closely related to diabetes and obesity. And some studies show that the level of SFRP5 in T2 DM patients is significantly higher, and it is positively correlated with fasting blood glucose[1]. The causal relationship between diabetes mellitus and SFRP5 is still inconclusive. Whether chronic inflammation which is related to diabetes and obesity stimulates the level of SFRP5, or the elevation of SFRP5 level stimulates the body of chronic inflammation and accelerates the process of diabetes and obesity is still not very clear. At present, the study of the effect of SFRP5 acting on Wnt signaling pathway on diabetic bone metabolism is only found in some animal experiments, and there is no relevant study to explore the relationship between SFRP5 and bone metabolism in patients with T2 DM.The purpose of this study was to investigate the relationship between SFRP5 level as well as diabetic related factors and bone mineral density(BMD) in patients with T2 DM, and to provide a basis for the study of the relationship between T2 DM and osteoporosis and for the treatment of osteoporosis.Methods: A total of 80 T2 DM inpatients were included in our hospital of Endocrinology Department from March 2014 to December 2014. We recorded in patients with general information, duration of diabetes and other information, determinated glycosylated hemoglobin(Hb Alc), measured the level of serum SFRP5 by enzyme- linked immunosorbent adsorption assay(ELISA), and used dual energy X-ray absorptiometry to detecte the BMD of lumbar spine and hips. The patients were divided into three groups according to the diagnostic criteria of osteoporosis(DEXA), 34 of them were in normal group, 25 were in bone loss group and 21 were in osteoporosis group(OP), and the SPSS13.0 was used for statistical analysis.Results:1 There was no significant difference among BMI,Hb A1 c and duration in three groups.2 In the three groups of patients, multiple linear regression analysis showed that BMI was positively related with the BMD of the lumbar spine,right hip and LG.T, Hb A1 c and bilateral hip BMD showed negative correlation, age and the BMD of the RG.T, Rward, LG.T showed negative correlation. Gender was related to the BMD of double hip and lumbar 2-3. The BMD of double hip and lumbar 2-3 in male was higher than that in female. The course of disease has nothing to do with the BMD.3 By non parametric test Kruskal Wallis test(p < 0.05), The level of SFRP5 in osteoporosis group was highest, the SFRP5 level in normal group was lowest, and that in bone loss group was between the two.4 There was statistically significant differences in the mean bone mineral density and SFRP5 levels of all patients by rank correlation analysis, which indicated that the level of SFRP5 was negatively related to BMD.Conclusions:1 Age, Hb A1 c are the adverse factors of BMD in type 2 diabetic patients, and BMI is a favorable factor. The BMD in male is better than that in female, the course of diabetes has no effect on BMD.2 In T2 DM with osteoporosis, the level of SFRP5 is increased, which is negatively related to BMD.