Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1527
Peer-review started: November 14, 2021
First decision: December 9, 2021
Revised: December 27, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 16, 2022
Processing time: 88 Days and 21.4 Hours
Osteoporosis is a systemic bone disease characterized by decreased bone mass, impaired bone mass, and reduced bone strength that leads to increased bone fragility and fracture. Type 2 diabetes mellitus (T2DM) complicated with osteoporosis is a common systemic metabolic bone disease, and reduced bone mass and bone strength are considered the main clinical features; however, the pathogenesis of this disease has not been fully clarified. Its occurrence is considered related to sex, age, and genetic factors. There are many risk factors for diabetes complicated with osteoporosis. Therefore, exploring these risk factors will help prevent it.
To investigate the relationships among serum glucagon-like peptide-1 (GLP-1) levels, matrix Gla protein (MGP) levels, and diabetes with osteoporosis.
Sixty patients with T2DM complicated with osteoporosis confirmed by the endocrinology department of our hospital were selected as the case group. Sixty T2DM patients with bone loss were selected as the control group. Sixty healthy participants were selected as the healthy group. The general data, bone mineral density index, and bone metabolic markers of the three groups were compared. The relationships among GLP-1 levels, MGP levels, and the bone mineral density index of the case group were analyzed using linear correlation analysis and a logistic regression model.
Differences in sex, smoking, and drinking among the case group, control group, and healthy group were not statistically significant (P > 0.05). The mean age of the case group was older than those of the control and healthy groups (P < 0.05). The body mass index, fasting plasma glucose level, HbA1c level, hypertension rate, and coronary heart disease rate of the case and control groups were higher than those of the healthy group (P < 0.05). The serum GLP-1 and MGP levels of the case group were lower than those of the control and healthy groups; these differences were statistically significant (P < 0.05). The serum GLP-1 and MGP levels of the control group were lower than those of the healthy group; these differences were statistically significant (P < 0.05). The serum GLP-1 and MGP levels of the case group were significantly positively correlated with the bone mineral density values of the hip and lumbar spine (P < 0.05). The results of the logistic regression model showed that age and duration of diabetes were independent risk factors for osteoporosis in diabetic patients (P < 0.05) and that increased GLP-1 and MGP values were protective factors against osteoporosis in diabetic patients (P < 0.05).
Serum GLP-1 and MGP levels of diabetic patients with osteoporosis were significantly decreased and positively correlated with bone mineral density and were independent risk factors for osteoporosis in diabetic patients.
Core Tip: Serum glucagon-like peptide-1 (GLP-1) and matrix Gla protein (MGP)levels were significantly positively correlated with bone mineral density values of the hip joint and lumbar vertebrae. They were significantly negatively correlated with type 1 procollagen amino-terminal propeptide, osteocalcin, and special sequence of carboxy-terminal peptide β of type 1 collagen. Older age and duration of diabetes were independent risk factors for osteoporosis for diabetic patients. Increased GLP-1 and MGP levels were protective factors against osteoporosis for diabetic patients. GLP-1 and MGP levels should be used as auxiliary evaluation indexes to evaluate the risk of osteoporosis for patients with diabetes to enable early detection of and intervention for diabetes with osteoporosis and improve its prognosis.