Expression of Serum FGF1,NT5E and 25(OH)D in T2DM Patients with Osteoporosis and Their Association with Glucose and Lipid Metabolism and Bone Metabolism
Objective To investigate the expression of serum basic fibroblast growth factor 1(FGF1),human ecto-5'-nucleotidyase(NT5 E),and 25-hydroxy vitamin D[25(OH)D]in type 2 diabetes mellitus(T2DM)patients with osteoporosis,and to analyze their association with glucose and lipid metabolism and bone metabolism.Methods A total of 94 T2DM patients with osteoporosis and 94 T2DM patients without osteoporosis were selected from the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023,and were included in the group with osteoporosis and the group without osteoporosis,respectively.The levels of serum FGF1,NT5E,25(OH)D and the related indexes of glucose and lipid metabolism and bone metabolism glycated hemoglobin A1c(HbA1c),fasting blood glucose(FPG),fasting insulin(FINS),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),total cholesterol(TC),homeostasis model assessment insulin resistance index(HOMA-IR),bone alkaline phosphatase(B-ALP),N-terminal med fragment of osteocalcin(N-MID),β-isomer of the C-terminal telopeptide of type Ⅰ collagen(β-CTX),osteocalcin(OCN),tartrate-resistant acid phosphatase 5b(TRACP-5b),procollagen Type ⅠN-terminal propeptide(PⅠ NP)]were compared between the two groups.The serum levels of FGF1,NT5E and 25(OH)D were compared in patients with different degrees of osteoporosis,and the correlation between these three indexes and glucose and lipid metabolism,bone metabolism and osteoporosis degree was analyzed,and their diagnostic efficacy was evaluated.Results The levels of serum FGF1,NT5E,HbA1c,HOMA-IR,TC,N-MID,β-CTX,OCN and TRACP-5b in the group with osteoporosis were higher than those in the group without osteoporosis,and the levels of 25(OH)D,B-ALP and P Ⅰ NP were lower than those in the non-osteoporosis group(P＜0.05).Comparison of serum FGF1 and NT5E levels in patients with different degrees of osteoporosis showed that patients with degree 3 were lower than those with degree 2,and patients with degree 2 were lower than those with degree 1.The level of 25(OH)D in patients with grade 3 was higher than that in patients with degree 2,and that in patients with degree 2 was higher than that in patients with degree 1(P＜0.05).Serum FGF1 and NT5E levels were positively correlated with HbA1 c,HOMA-IR,TC,N-MID,β-CTX,OCN and TRACP-5b,and negatively correlated with B-ALP,P Ⅰ NP and the degree of osteoporosis.Serum 25(OH)D was negatively correlated with HbA1c,HOMA-IR,TC,N-MID,β-CTX,OCN and TRACP-5b,and positively correlated with B-ALP,P Ⅰ NP and the degree of osteoporosis.The area under the curve(AUC)of the combination of each index in the diagnosis of osteoporosis was 0.923,and it was larger than three indicators alone(P＜0.05).Conclusion The expression of FGF1 and NT5E in serum of T2DM patients with osteoporosis is up-regulated,and the expression of 25(OH)D is down-regulated.The levels of each index are correlated with glucose and lipid metabolism,bone metabolism and the degree of osteoporosis.The combined detection has certain diagnostic value for T2DM patients with osteoporosis,and can be used as an adjuvant index for clinical diagnosis of the disease.
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