Expression and clinical significance of serum C1q/tumor necrosis factor related protein 3 in diabetes patients complicated with osteoporosis

LI Qian; WANG Shuo; CHEN Yarong; LI Shan; JIN Dandan; GAO Yan

doi:10.7619/jcmp.20230193

Journal of Clinical Medicine in Practice > 2023 > 27(12): 57-62. > DOI: 10.7619/jcmp.20230193

LI Qian, WANG Shuo, CHEN Yarong, LI Shan, JIN Dandan, GAO Yan. Expression and clinical significance of serum C1q/tumor necrosis factor related protein 3 in diabetes patients complicated with osteoporosis[J]. Journal of Clinical Medicine in Practice, 2023, 27(12): 57-62. DOI: 10.7619/jcmp.20230193

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Expression and clinical significance of serum C1q/tumor necrosis factor related protein 3 in diabetes patients complicated with osteoporosis

the Third Department of Internal Medicine, Xingtai General Hospital of North China Medical and Health Group, Xingtai, Hebei, 054000

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Received Date: January 30, 2023
Revised Date: April 10, 2023
Available Online: July 07, 2023

Graphical Abstract

Abstract

Abstract

Objective
To explore the expression level and clinical significance of serum C1q/tumor necrosis factor related protein 3 (CTRP3) in diabetes patients complicated with osteoporosis.
Methods
A total of 93 type 2 diabetes patients complicated with osteoporosis from January 2020 to December 2021 were selected as observation group, and 80 patients with simple type 2 diabetes in the same period were selected as control group. The clinical materials such as demographic data, glucose and lipid metabolism indicators, bone metabolism indicators and bone mineral density in both groups were retrospectively analyzed, and the serum CTRP3 level in both groups was detected by enzyme-linked immunosorbent assay. Multiple linear regression analysis was used to analyze the correlations of serum CTRP3 with glucose and lipid metabolism indicators, bone metabolism indicators and bone density; the Logistic regression model was used to analyze the influencing factors of osteoporosis; the receiver operating characteristic (ROC) curve was used to evaluate the value of serum CTRP3 in diagnosing type 2 diabetes patients complicated with osteoporosis.
Results
In the observation group, the ratios of female patients and patients with smoking history were significantly higher than those in the control group, the age was significantly older than that in the control group, the course of diabetes was significantly longer than that in the control group, the fasting blood glucose (FBG), insulin resistance index (HOMA-IR), fasting insulin (FINS), glycated hemoglobin (HbA1c), N-terminal middle molecular fragment of osteocalcin (N-MID), β isomer of C-terminal telopeptide of type Ⅰ collagen (β-CTX) and tartrate-resistant acid phosphatase 5b (TRACP-5b) levels were significantly higher than those in the control group, while serum CTRP3 level, body mass index (BMI), bone mineral density, propeptide of type Ⅰ procollagen (PINP), carboxyterminal propeptide of type Ⅰ procollagen (PICP) and bone alkaline phosphatase (B-ALP) were significantly lower than those in the control group (P < 0.05). FBG, HOMA-IR, FINS, HbA1c, N-MID, β-CTX and TRACP-5b were negatively correlated with CTRP3 level (P < 0.05), while PINP, PIC and B-ALP were positively correlated with CTRP3 level (P < 0.05). Logistic regression analysis model showed that FBG, HOMA-IR, FINS, HbA1c, CTRP and bone density as well as bone metabolism indicators were the independent influencing factors of type 2 diabetes patients complicated with osteoporosis (P < 0.05), of which FBG, HOMA-IR, FINS, HbA1c, N-MID, β-CTX and TRACP-5b were risk factors (OR>1, P < 0.05), and CTRP3, bone density, PINP, PICP and B-ALP were protective factors (OR < 1, P < 0.05). The area under the curve (AUC) of CTRP3 in diagnosing osteoporosis was 0.815, and the sensitivity and specificity were 84.95% and 63.75% respectively; the AUC of CTRP3 combined with BMD in diagnosing osteoporosis was 0.882, and the sensitivity and specificity were 83.87% and 78.75% respectively.
Conclusion
Serum CTRP3 is downregulated in diabetes patients with osteoporosis, and is closely related to glucose metabolism disorder, bone metabolism abnormality and bone density reduction, which can affect the occurrence of osteoporosis in diabetes patients.
- type 2 diabetes,
- osteoporosis,
- C1q/tumor necrosis factor related protein 3,
- glucose and lipid metabolism,
- bone metabolism,
- bone mineral density

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References (26)

References

[1]	REID I R. A broader strategy for osteoporosis interventions[J]. Nat Rev Endocrinol, 2020, 16(6): 333-339. doi: 10.1038/s41574-020-0339-7
[2]	宋茜茜, 尹飞, 郭淑芹, 等. 2型糖尿病合并骨质疏松症患者血清CX3CL1、CCL3、CCL4与糖脂代谢、骨密度及骨代谢标志物的相关性[J]. 疑难病杂志, 2022, 21(8): 828-833. https://www.cnki.com.cn/Article/CJFDTOTAL-YNBZ202208010.htm
[3]	王敏, 耿亚辉. 2型糖尿病合并骨质疏松危险因素的研究进展[J]. 北京医学, 2022, 44(7): 636-639. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX202207014.htm
[4]	梁瑞杰, 田燕华, 姚佳慧, 等. 2型糖尿病患者骨质疏松发生风险及认知现状[J]. 上海护理, 2021, 21(8): 29-33. https://www.cnki.com.cn/Article/CJFDTOTAL-SHHL202108011.htm
[5]	中华医学会骨质疏松和骨矿盐疾病分会, 中华医学会内分泌学分会, 中华医学会糖尿病学分会, 等. 糖尿病患者骨折风险管理中国专家共识[J]. 中华糖尿病杂志, 2019, 11(7): 445-456. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH202210002.htm
[6]	LI Y, WRIGHT G L, PETERSON J M. C1q/TNF-related protein 3 (CTRP3) function and regulation[J]. Compr Physiol, 2017, 7(3): 863-878.
[7]	廖宏伟, 李学栋, 马金锋. 血清CTRP3及PGC-1α表达与创伤性骨折愈合的相关性分析[J]. 中国骨伤, 2022, 35(11): 1059-1064. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGU202211009.htm
[8]	冯刚, 肖登, 王翠婷, 等. 血清脂肪因子-CTRP3水平与绝经后妇女骨密度相关性研究[J]. 中国骨质疏松杂志, 2019, 25(6): 789-792. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201906012.htm
[9]	XU Z H, ZHANG X, XIE H, et al. Serum CTRP3 level is associated with osteoporosis in postmenopausal women[J]. and, 2018, 126(9): 559-563.
[10]	陆菊明. 《中国2型糖尿病防治指南(2020年版)》读后感[J]. 中华糖尿病杂志, 2021, 13(4): 301-304.
[11]	夏维波, 章振林, 林华, 等. 原发性骨质疏松症诊疗指南(2017)[J]. 中国骨质疏松杂志, 2019, 25(3): 281-309. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201903001.htm
[12]	孙景熙, 陈剑明, 王福斌. 2型糖尿病合并骨质疏松患者血清PINP与β-CTX和糖代谢指标相关性分析[J]. 中国卫生检验杂志, 2022, 32(15): 1844-1846. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ202215013.htm
[13]	SINCLAIR A, SAEEDI P, KAUNDAL A, et al. Diabetes and global ageing among 65-99-year-old adults: findings from the International Diabetes Federation Diabetes Atlas, 9^th edition[J]. Diabetes Res Clin Pract, 2020, 162: 108078.
[14]	POIANA C, CAPATINA C. Osteoporosis and fracture risk in patients with type 2 diabetes mellitus[J]. Acta Endocrinol, 2019, 15(2): 231-236.
[15]	张清文, 卫俊杰. 糖尿病性骨质疏松症发病机制的研究进展[J]. 现代临床医学, 2022, 48(5): 378-380. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCD202205018.htm
[16]	胡晓, 常小倩, 宋延彬. CTRP3研究新进展[J]. 生理科学进展, 2020, 51(4): 299-304. https://www.cnki.com.cn/Article/CJFDTOTAL-SLKZ202004015.htm
[17]	钱子冰, 张琦, 曾佩芸, 等. 补体C1q/肿瘤坏死因子相关蛋白中CTRP3、CTRP5、CTRP9、CTRP13生物学研究进展[J]. 中国糖尿病杂志, 2022, 30(5): 379-382. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTL202205011.htm
[18]	徐园园, 魏迎凤, 卢学超, 等. 血清CTRP3水平对2型糖尿病周围神经病变的作用[J]. 微循环学杂志, 2022, 32(2): 45-49, 53. https://www.cnki.com.cn/Article/CJFDTOTAL-WXHX202202008.htm
[19]	DING H, WANG Z, SONG W. CTRP3 protects hippocampal neurons from oxygen-glucose deprivation-induced injury through the AMPK/Nrf2/ARE pathway[J]. Hum Exp Toxicol, 2021, 40(7): 1153-1162.
[20]	LI X, JIANG L, YANG M, et al. Impact of weight cycling on CTRP3 expression, adipose tissue inflammation and insulin sensitivity in C57BL/6J mice[J]. Exp Ther Med, 2018, 16(3): 2052-2059.
[21]	宁海峰, 朱迎庆. 补体C1q/肿瘤坏死因子相关蛋白3在老年型骨折中的临床应用价值[J]. 中国老年学杂志, 2018, 38(24): 5991-5992. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201824044.htm
[22]	任亚丽, 卢学超, 解其华, 等. CTRP3、TGF-β1在糖尿病肾病中的表达及相关性研究[J]. 扬州大学学报: 农业与生命科学版, 2022, 43(2): 92-97, 103. https://www.cnki.com.cn/Article/CJFDTOTAL-JSNX202202012.htm
[23]	XU H, WANG Z D, LI X R, et al. Osteoporosis and osteopenia among patients with type 2 diabetes aged ≥50: role of sex and clinical characteristics[J]. J Clin Densitom, 2020, 23(1): 29-36.
[24]	付梦菲, 李欢, 张欢, 等. 中国2型糖尿病人群合并骨质疏松症危险因素的Meta分析[J]. 华中科技大学学报: 医学版, 2021, 50(1): 94-100. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYX202101019.htm
[25]	杨弦弦, 丁贤彬, 唐文革, 等. 重庆市监测人群骨质疏松症患病率及其影响因素分析[J]. 公共卫生与预防医学, 2022, 33(1): 90-94. https://www.cnki.com.cn/Article/CJFDTOTAL-FBYF202201019.htm
[26]	兰魁勇, 王伟, 沈俊宏, 等. 2型糖尿病合并骨质疏松患者的骨代谢指标变化分析[J]. 新疆医科大学学报, 2022, 45(1): 70-74. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY202201011.htm