The Correlation Between Bone Metabolism Factors And Left Ventricular Function In Patients With Type 2 Diabetes Mellitus

Objective:The recent studies have found that bone metabolic factors play a role in regulating blood glucose and lipid,but the relationship between bone metabolism factors and left ventricular function is not clear.This study we investigated the correlation between bone metabolic factors and left ventricular function in patients with type 2 diabetes mellitus.Methods:The 390 patients with type 2 diabetes mellitus were divided into four groups:the T2DM group;the T2DM with subclinical AS group;the T2DM with microvascular complications group;the T2DM with macrovascular complication group.Serum concentrations of osteocalcin（OC）,beta collagen specific sequences（β-CTX）,25 hydroxy vitamin D3（25（OH）D3）,parathyroid hormone（PTH）,calcium（Ca）,phosphorus（P）,fasting blood glucose（FBG）,glycosylated hemoglobin（HbA₁C）,fasting insulin（FINS）,total cholesterol（TC）,triglyceride（TG）,high density lipoprotein（HDL-C）,low density lipoprotein（LDL-C）,uric acid（UA）,high sensitivity c-reactive protein（hs-CRP）,sialic acid（SA）,homocysteine（HCY）and Cystatin（Cys-c）were measured.And echocardiography have measured diastolic interventricular septal thickness（IVSTs）,systolic interventricular septal thickness（IVSTs）,left ventricular end diastolic diameter（LVDd）,left ventricular end systolic diameter（LVDs）,left ventricular diastolic posterior wall thickness（LVPWTd）,left ventricular systolic posterior wall thickness（LVPWTs）,left ventricular ejection fraction（LVEF）,left ventricular fractional shortening（LVFS）,early diastolic mitral flow velocity/end diastolic mitral flow velocity（E/A ratio）,calculated left ventricular mass index（LVMI）.Results:Compared with T2DM group,OC andβ-CTX were significantly decreased in the T2DM with subclinical AS group,the T2DM with microvascular complications group,the T2DM with macrovascular complication group.The difference was statistically significant（P<0.05）.But 25（OH）D3,PTH was no difference between four groups compared with the T2DM group.Linear analysis showed that the LVEF was negatively correlated with TC,TG and UA,and positively correlated with OC;E/A was negatively correlated with BMI,HbA1C,HOMA-IR,TC,TG,LDL-C,UA,hs-CRP,SA,HCY,Cys-c,UAER,and positively correlated with the OC,β-CTX,Ca,P.LVMI was negatively correlated with OC andβ-CTX,and was positively correlated with BMI,HOMA-IR,hs-CRP,HCY,and UAER.Multiple linear regression analysis showed that OC,β-CTX,UA,HCY,Cys-c and TC are independent factors of cardiac function;Logistic regression analysis showed that OC andβ-CTX are protective factors of cardiac function in patients with diabetes,UA,TC,LDL-C,HbA1C are risk factors for left ventricle.There was no correlation between 25（OH）D3,PTH and left ventricle.Conclusion:The concentration of serum OC andβ-CTX in T2DM with vascular complications are significantly lower than T2DM.OC andβ-CTX may be the protective factors for the heart function of type 2 diabetes mellitus.