Studies On The Relationship Between Serum Retinol Binding Protein 4 And Bone Morphogenetic Protein 2 And Bone Metabolism And Bone Mineral Density In Type 2 Diabetic Patients

Objective: Discuss the relationship between serum RBP4?BMP2 and bone metabolism and bone mineral density in middle-aged and elderly men with type 2diabetes.Methods:82 male patients with type 2 diabetes were selected from the geriatric department and the Department of Endocrinology affiliated to Qinghai University from February 2019 to August 2019.The BMD were measured by dual energy X-ray.According to the WHO diagnosis standard of osteoporosis,the subjects were divided into 29 cases with normal bone mass,27 cases with decreased bone mass and 26 cases with osteoporosis group.Record each person's age,height,weight,waist circumference,duration of diabetes,calculate BMI;detect FPG,FINS,Hb A1 c,TG,TC,HDL-C,LDL-C,ALP,Ca,P,PTH and calculate HOMA-? and HOMA-IR.ELISA was used to determine serum PINP,?-CTX,RBP4 and BMP2 levels.Statistical analysis was performed on the data using SPSS21,The normal distribution measurement data are represented by mean±standard deviation(X ±S),the non-normal distribution count data is represented by median M(P25,P75),when the distribution is in accordance with the normal distribution and the variance is homogeneous,one-way ANOVA is used for the comparison between groups;when the distribution is not in accordance with the normal distribution,nonparametric testis used,and Kruskal Wallis test is selected.Spearman correlation analysis among the indexes.Influencing factors using binary Logistic regression.The inspection level is?=0.05.Results:(1)There was no statistical difference in age,height,waist circumference,course of disease,HOMA-IR,HOMA-?,Hb A1 c,TC,TG,HDL-C,LDL-C,ALP,Ca,P and PTH among the three groups.There were significant differences in BMI.the normal group was higher than the osteopenia group and the osteoporosis group,and the osteopenia group was higher than the osteoporosis group.(2)There were significant differences in serum PINP,?-CTX,RBP4 and BMP2 levels and BMD of various parts among the three groups.The PINP,RBP4 and BMD of various parts in normal bone mass group was higher than that in decreased bone mass group and osteoporosis group,and the PINP,RBP4 and BMD of various parts in decreased bone mass group was higher than that in osteoporosis group,?-CTX,BMP2 was the opposite.(3)The results of Spearman correlation analysis showed that RBP4 was positively correlated with PINP and BMD of all parts(p<0.05),negatively correlated with ?-CTX(p<0.01),and had no correlation with BMP2;BMP2 was positively correlated with ?-CTX(p<0.05),negatively correlated with BMD of all parts(p<0.05).(4)The binary Logistic regression showed that with the decrease of BMI and serum RBP4 levels,the risk of bone mineral density decreased in middle-aged and elderly men T2 DM patients increased.Conclusion:1.Serum RBP4 can promote bone formation and inhibit bone resorption in middle-aged and old men with type 2 diabetes.2.elevated BMP2 in middle-aged and elderly men with type 2 diabetes can contribute to osteoporosis and promote bone resorption.3.Low BMI and RBP4 levels are risk factors for the decrease of BMD in middle-aged and old male T2 DM patients.