Effects Of Fat Mass Percentage And Sclerostin On Bone Health In Middle-aged And Elderly Patients With Type 2 Diabetes Mellitus

BackgroundThe abnormalities of glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM)plays an important role on bone health,Osteoporosis(OP)is an important manifestation of bone damage,Bone mineral density(BMD)and Bone biochemical markers are the important indicators of assess bone health.Studies found that,Sclerostin(SOST)was significantly associated with the falling risk of patients with T2DM,But the relationship between SOST and BMD is still controversial.Body composition,especially muscle tissue,has an important impact on bone.Nevertheless,there is no agreement on the effects of adipose tissue on bone.This study was to investigate the effect of SOST and FM% on BMD and bone metabolism of middle-aged and elderly patients with type 2diabetes mellitus by observing the correlation analysis of fat mass percentage and sclerostin with bone health in middle-aged and elderly patients with type 2 diabetes mellitus.Objectives1.Comparison and analysis the change of BMD and t-P1 NP of middle-aged and elderly patients with T2DM,and to learn the the current situation about bone health.2.Analysis the change of FM%,Analysis the correlation of it and BMD,t-P1 NP in middle-aged and elderly patients with T2DM.3.Analysis the correlation of change of SOST and BMD,t-P1 NP in middle-aged and elderly patients with T2DM.4.Comparison and analysis the change of FM% and SOST impact on BMD and t-P1 NP in middle-aged and elderly patients with T2DM,Composite analysis the impact of SOST and FM% on bone health.Methods1.Subjects: Selected type 2 diabetes patients 128 cases from June 2014 to January2015 among hospitalized patients in the department of Endocrinology and Metabolism in He Nan provincial people's hospital,and healthy people 64 cases as control group from health examination center.2.Collecting the average materials,height and weight measured by special person,and calculate the Body Mass Index(BMI),BMI=Weight(Kg)/ Height(m2).Collection the blood samples and serums were sampled.3.The dual energy X ray absorptiometry was utilized to determine the bone mineral density in lumbar(L1-4)and left femoral.and the FM% in the same areas.Selected biochemical indexes such as calcium,phosphate,low-density lipoproteins,high-density lipoproteins,Serum creatinine and blood urea,Alkaline,Phosphatase and Hemoglobin Al C,fasting glucose.4.According to the diagnosis standard of T2DM,The subjects were divided into two groups,T2DM and Non-DM,Comparison the level of BMD and t-P1 NP to assess the bone health of middle-aged and elderly patients with T2DM.Pearson's correlation was used to analysis the correlation of FM% with BMD and the correlation of FM% and t-P1 NP of T2DM.5.Statistical analysis,The date were processed with SPSS19.0 statistical software package,and P <0.05 was considered statistically significant.Results1.The level of t-P1 NP was lower than the control group [P1NP(35.17±19.53)ng/ml vs(42.41±19.43)ng/ml P<0.05],But the difference of lumbar and femoral BMD between the diabetes group[(1.11±0.16)cm2/g,(0.98±0.15)cm2/g] and the control group[(1.09±0.18)cm2/g,(0.98±0.19)cm2/g] has no statistically significant.The level of SOST in the diabetes group[(224.92±76.94)pg/ml] is higher than that in control group[(193.37±61.91)pg/ml](P < 0.01),The femoral FM% of the diabetes group[(23.79±5.98)%]is still higher than the control group [(21.98±5.06)% ](P<0.05).2.Correlation analysis showed that(1)Correlation between FM% of femoral and BMD of lumbar and femoral were negative significant(r =-0.211,P=0.020;r =-0.287,P=0.001),But there is no correlation between the FM% of lumbar and BMD of both lumbar and femoral(r =-0.017,P=0.854;r =-0.166,P=0.064)FM% of femoral,lumbar and t-P1NP(r =0.042,P=0.702;r=-0.088,P=0.420)has no correlation.The FM% of lumbar and femoral was significantly positively correlated with SOST(r =0.265,P=0.016;r =0.303,P=0.005).(2)Correlation between SOST and t-P1 NP were negative significant(r =-0.248,P=0.038;r =-0.278,P=0.026),But there has no correlation between SOST and BMD of lumbar(r =-0.013,P=0.904),femoral(r =-0.142,P=0.199).Conclusions1.The BMD of the T2DM group has no difference compared with the control group,But the level of t-P1 NP were lower than the control group.The bone formation of T2DM is lower than the control group.2.The FM% of T2DM of middle-aged and elderly patients is an affecting factors of bone loss,The increase of SOST,Would be an important factor of the lower bone turnover of T2DM of middle-aged and elderly patients.3.The middle-aged and elderly patients with type 2 diabetes mellitus with higher level of FM% and SOST.People of them has lower bone turnover and weak bone micro-architecture,Which is bad for bone health.