Relationship Between Bone Turnover Markers And Microvascular Complications In Type 2 Diabetes Patients

Objective:The aim of this study was to assess whether bone turnover markers are associated with diabetes micro-vascular complications by comparing the general data,metabolic markers and BTMs.providing new ideas for clinical diagnosis.Methods:A total of 146 type 2 diabetes patients(77 patients with diabetic microvascular complications as a case group and 69 patients without retinopathy and/or nephropathy)as a control group were recruited in this case–control study.The general data and metabolic markers were assessed in all patients.Including age,history,BMI,blood pressure,glycated hemoglobin Alc(HbAlc),uric acid(UA),serum creatinine(CRE),blood urea nitrogen(BUN),total triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL).Bone turnover markers were assessed in all patients including P1NP,CTX and OC.All data using SPSS 22.0 software for statistical analysis.Measurement data in accordance with normal distribution are expressed as x~2±s,and Student's t test are performed;Non-conforming to the normal distribution are expressed as the median(interquartile range),Mann-Whitney U test are performed.A Pearson correlation was used to determine correlation between bone turnover markers and metabolic markers.Binary logistic regression analysis was used to determine an independent association between bone turnover markers and diabetes micro-vascular complications.Two-tailed p-values less than 0.05 were considered significant.Results:1 Comparison of general data and metabolic markers between the two groupsCompared with the control group,the diabetes microvascular complications group had longer duration of diabetes and higher serum CRE levels,and the difference was significant(P<0.05).No significant differences were found in other indicators.2 Comparison of two sets of bone turnover markers and BMDThere was a increase trend in serum CTX levels(P=0.042)and a tendency to be lower in serum levels of OC among patients in case group(P=0.032).There was no significant difference in serum levels of P1NP among the groups.3 Correlation between bone turnover markers and metabolic markersIn the diabetic microvascular complications group,P1NP was positively correlated with BUN(r=0.440,P=0.001),OC was positively correlated with BUN(r=0.332,P=0.003)and HDL(r=0.317,P=0.005).4 Binary logistic regression analysis of risk factors of diabetic microvascular complications.Taking duration of diabetes,CRE,CTX and OC as independent variables,Binary logistic regression analysis was performed with or without diabetic microvascular complications as the dependent variable.The results showed that:higher serum CTX(OR=0.011,95%CI:0.001-0.226;P=0.003)patients have a higher risk of microvascular complications.Patients with higher serum OC levels may have a lower risk of diabetic microvascular complications(OR=0.91,95%CI:0.83-0.99;P=0.032).Conclusion:In patients with type 2 diabetes,bone turnover markers such as CTX have a significant association with diabetic microangiopathy and may be a specific marker for monitoring microvascular complications and bone metabolism.