Relationship Between Bone Turnover Markers And Microangiopathy In Type 2 Diabetic Patients

Objective:Through observing the biochemical metabolic index,bone turnover markers,microalbuminuria and retinopathy in patients with type 2 diabetes mellitus,the correlation between bone turnover markers and diabetic microvascular complications and other metabolic factors of diabetes mellitus was explored.Method:301 adults with type 2 diabetes who visited the Third Affiliated Hospital of Anhui Medical University from August 2015 to September 2017 were selected as study subjects.Patients with microalbuminuria and/or retinopathy were enrolled in the study(138 cases,47.19 ± 4.84 years)without microalbuminuria and retinopathy(163 cases,46.94 ± 6.53 years).Patients in the study group were recorded gender,age,height,weight,blood pressure,diabetes history 'and current drug use,and blood glucose,blood lipids,liver and kidney function,glycosylated hemoglobin,fasting C-peptide,parathyroid' hormone,25' hydroxyvitamin D3,Bone turnover markers(PINP and?-CTX),urinary albumin to creatinine ratio,and fundus microangiopathy.The differences of PINP,?-CTX and related data of type I procollagen between the two groups were compared by statistical analysis,and the correlation between the two groups of bone turnover markers Sexual analysis.Result:1.The comparison of general data and diabetes-related factors between the two groups showed that there was no significant difference between the two groups in terms of age,gender,medical history,BMI,history of hypertension,SBP,DBP,dyslipidemia,obesity and poor control of blood glucose(P>0.05).2.Compared with the control group,the levels of HbAlc,TC,TG,BUN,Cr,UA,PTH and ?-CTX in the experimental group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Compared with the control group,25(OH)D3 decreased significantly(P<0.001),while the level of PINP in the experimental group was significantly higher than that of the control group(P>0.05).3.The comparison of bone turnover markers in different sexes found that male PINP and ?-CTX levels were lower than those in premenopausal women,but the difference was not statistically significant(P>0.05).4.Comparisons of different types of microvascular complications in BTMs revealed that PINP in DN/DR group was significantly higher than that in non-micro vascular complications group(P<0.001),and there was significant difference between DR group and DN/DR group(P<0.01,P<0.001).The level of ?-CTX in DN group was lower than that in DN/DR group(P<0.05).5.Correlation analysis between BTMs and various parameters in two groups showed that there was no significant difference between ?-CTX and BUN(r =-0.431,P=0.013),Cr(r =-0.602,),25(OH)D3(r =-0.703,P = 0.036),and had positive correlation with HbAlc(r= 0.235,P-0.030)and PTH(r = 0.652,P = 0.000).Conclusion:In type 2 diabetes mellitus with microalbuminuria and retinopathy,beta-CTX increased significantly,suggesting that beta-CTX might be a specific marker for monitoring bone metabolism in patients with type 2 diabetes mellitus with microangiopathy.