The Relationship Between Estimated Glucose Disposal Rate And Bone Turnover Markers In Type 2 Diabetes Mellitus

Objective: To investigate the relationship between estimated glucose disposal rate(eGDR)and bone turnover markers in patients with type 2diabetes mellitus(T2DM).Methods: 549 adult male and postmenopausal female T2DM patients treated in the Hebei General Hospital from December 2018 to August 2019 were selected,and clinical informations were collected.Osteocalcin(OC),type Ⅰ collagen carboxyl terminal peptide(β-CTX)and type Ⅰ procollagen amino-terminal peptide(PINP)and other indicators were measured.The eGDRs of patients were calculated based on the presence of hypertension,glycated hemoglobin(HbA1c),and body mass index(BMI).All patients were divided into high-eGDR group and low-eGDR group using the median of eGDR as the boundary.The patients were further divided into two subgroups:males and postmenopausal females.The data were analyzed using SPSS25.0statistical software,and correlation analysis and multiple linear regression analysis were used to investigate the correlation between eGDR and bone turnover markers.Results:1.The levels of OC,β-CTX,PINP and vitamin D(25(OH)D)were significantly lower in low eGDR group compared with the high eGDR group(P < 0.05).2.Compared to postmenopausal female group,the levels of OC,β-CTX and PINP were lower(P < 0.05)in male group,but there was no significant difference in vitamin D level and eGDR between the two groups(P > 0.05).3.Correlation analysis showed that eGDR was positively correlatedwith OC,β-CTX and PINP in all T2DM patients(P < 0.05).In male T2DM patients,eGDR was also positively correlated with OC,β-CTX and PINP,whereas there was no correlation between eGDR and bone turnover markers in postmenopausal women(P > 0.05).4.eGDR levels are an independent influencing factor for bone turnover in all patients and male T2DM patients,after adjusting for age,disease duration,total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),scrum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),fasting blood glucose(FBG),25(OH)D in multilinear regression analysis.However,there was no correlation between eGDR and bone turnover markers in postmenopausal female with T2DM(P > 0.05).Conclusions:1.The bone formation marker of OC,PINP levels and bone resorption marker β-CTX levels were significantly lower in the low eGDR group than in the high eGDR group.2.In all T2DM patients and male T2DM patients,eGDR was positively correlated with OC,β-CTX,and PINP.This correlation was gender-specific,there was no correlation between eGDR and bone turnover markers in postmenopausal female T2DM patients.3.eGDR levels are an independent influencing factor for bone turnover in male T2DM patients.