老年2型糖尿病患者血清Apelin-13、sFRP4水平与骨质疏松症的关系研究OA

Objective To explore the relationship between serum adipocytokine Apelin-13 and secretory frizzled-related protein 4(sFRP4)levels and osteoporosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods From July 2021 to December 2024,total 225 elderly T2DM patients treated in our hospital were selected.Based on whether osteoporosis occurred,pa-tients were divided into an occurrence group(n=57)and a non-occurrence group(n=168).Clinical data,serum Apelin-13 and sFRP4 levels were compared.The correlation between serum Apelin-13,sFRP4 levels and bone mineral density(BMD),as well as bone metabolic indicators including type Ⅰ collagen carboxy terminal peptide beta specific sequence β-CTX,25-hydroxyvitamin D3[25(OH)D3],bone alkaline phosphatase(BALP),and type Ⅰ procollagen amino terminal extension peptide(PINP),was ana-lyzed.Factors related to osteoporosis in elderly T2DM patients were investigated,and the non-linear relationship between serum Apelin-13,sFRP4 levels and the risk of osteoporosis was explored.Additionally,the impact of the interaction between serum Ape-lin-13 and sFRP4 levels on the risk of osteoporosis in elderly T2DM patients was studied.Results In the occurrence group,the proportion of women,and β-CTX,BALP,and sFRP4 were higher,while BMD,PINP,25(OH)D3,and Apelin-13 were lower com-pared with the non-occurrence group(P＜0.05).In elderly T2DM patients with osteoporosis,serum Apelin-13 was negatively cor-related with β-CTX and BALP,and positively correlated with BMD,PINP,and 25(OH)D3(P＜0.05).Serum sFRP4 was posi-tively correlated with β-CTX and BALP,and negatively correlated with BMD,PINP,and 25(OH)D3(P＜0.05).Logistic regres-sion analysis indicated that both serum Apelin-13 and sFRP4 levels were influencing factors of osteoporosis in elderly T2DM pa-tients before and after adjusting for other confounding factors(P＜0.05).Restricted cubic spline(RCS)analysis showed a non-linear relationship between serum Apelin-13 and sFRP4 levels and the risk of osteoporosis in elderly T2DM patients(P＜0.05).Interaction analysis revealed an antagonistic effect between serum Apelin-13 and sFRP4 levels on the risk of osteoporosis in elderly T2DM patients(P＜0.05).Conclusion In elderly patients with T2DM,a decrease in serum Apelin-13 and an increase in sFRP4 are associated with the occurrence of osteoporosis.There may be an antagonistic effect,which jointly disrupts the dynamic balance of bone formation and absorption,thereby increasing the risk of osteoporosis.