Study on Correlation Between Osteoclast Activity and Bone Metabolism Levels in Patients with Early Diabetic Kidney Disease of Deficiency of Both Qi and Yin Complicated with Blood Stasis Type
Abstract: Objective: To analyze the correlation between osteoclast activity and bone metabolism levels in patients with early diabetic kidney disease of deficiency of both qi and yin complicated with blood stasis type. Methods:A total of 90 cases of patients with early diabetic kidney disease of deficiency of both qi and yin complicated with blood stasis type were retrospectively selected as the study objects,and were divided into the normal bone mass group (25 cases), the bone mass reduction group (55 cases) and the osteoporosis group (10 cases) according to different T values of bone mineral density. The general data,the levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),parathyroid hormone (PTH),Nterminal propeptide of type Ⅰ precollagen (PINP),osteocalcin (OC),25-hydroxyvitamin D3 (25-OH-D3),β -Crosslaps and osteoclast-related cytokines [Macrophage colony-stimulating factor (M-CSF), Receptor Activator of Nuclear Factor- κB Ligand (RANKL)] were compared among all groups. Multivariate Logistic regression was used to analyze the factors affecting the occurrence of osteoporosis in patients with early diabetic kidney disease of deficiency of both qi and yin complicated with blood stasis type,and Pearson test was used to analyze the correlation between bone metabolism and osteoclast-related cytokines. Results: There was no significant difference being found in the comparison of the levels of FBG, HbA1c and PTH among the three groups (P>0.05). The levels of PINP, 25-OH-D3, and OC in the bone mass reduction group and osteoporosis group were lower than those in the normal bone mass group (P<0.05),while the levels of PINP, 25-OH-D3, and OC in the osteoporosis group were lower than those in the bone mass reduction group (P<0.05). The level of β-Crosslaps in the osteoposis group were higher than those of the bone loss group and normal bone mass group (P<0.05). The levels of M-CSF and RANKL in the normal bone mass group were lower than those in the bone mass reduction group and osteoporosis group (P< 0.05),and the levels of M-CSF and RANKL in the bone mass reduction group was lower than that in the osteoporosis group (P < 0.05). Decreased levels of PINP , 25-OH-D3 , OC and increased levels of β- Crosslaps were risk factors for the occurrence of osteoporosis in patients with diabetic kidney disease (P< 0.05). The levels of M-CSF and RANKL were positively correlated with the degree of bone mass loss in patients with early diabetic kidney disease of deficiency of both qi and yin complicated with blood stasis type (P<0.05). Conclusion:The activity of osteoclasts is related to bone mass loss in patients with early diabetic kidney disease of deficiency of both qi and yin complicated with blood stasis type. Detection of the levels of PINP,25-OH-D3,OC and β-Crosslaps can help predict the risk of osteoporosis in patients.