Abstract
Objective To study the relationship between miR-513a-5p,miR-149-3p with bone metabolism and insulin re-sistance in patients with type 2 diabetes mellitus(T2DM)combined with osteoporosis,and their clinical application value.Meth-ods T2DM patients diagnosed and treated in our hospital from April 2022 to April 2024 were collected and separated into a osteo-porosis group and a non osteoporosis group.The expression levels of serum miR-513a-5p and miR-149-3p were compared between two groups.Pearson was applied to analyze the correlation between serum miR-513a-5p,miR-149-3p with bone metabolism indica-tors and insulin resistance.Logistic was applied to analyze the factors associated with osteoporosis in T2DM patients.ROC was ap-plied to analyze the predictive value of serum miR-513a-5p and miR-149-3p for patients with T2DM combined with osteoporosis.Results The serum levels of miR-513a-5p and miR-149-3p in the osteoporosis group were greatly lower than those in non osteopo-rosis group(P＜0.05).There were significant differences in the course of diabetes,calcium supplementation,β-CTX,N-MID,PINP,25(OH)D3,insulin resistance index(x2/t=3.162,6.567,5.575,16.045,15.980,5.034,4.781)between the osteoporo-sis group and the non osteoporosis group(P＜0.05).The serum miR-513a-5p level in the osteoporosis group was negatively corre-lated with β-CTX,N-MID,and insulin resistance index(r=-0.342,-0.461,-0.318,P＜0.05),positively correlated with PINP and 25(OH)D3(r=0.427,0.353,P＜0.05),the level of miR-149-3p was negatively correlated with β-CTX,N-MID,and insulin resistance index(r=-0.437,-0.341,-0.373,P＜0.05),and positively correlated with PINP and 25(OH)D3(r=0.442,0.409,P＜0.05).The course of diabetes,β-CTX,N-MID,and insulin resistance index(OR=1.726,1.857,3.784,2.281)were risk factors for patients with T2DM combined with osteoporosis.Calcium supplementation,PINP,25(OH)D3,miR-513a-5p,miR-149-3p(OR=0.844,0.653,0.778,0.937,0.752)were protective factors for patients with T2DM combined with osteoporosis(P＜0.05).The AUC of serum miR-513a-5p,miR-149-3p,and their combination in the diagnosis of osteoporosis in T2DM patients was 0.833(95％CI 0.783～0.883),0.773(95％CI 0.717～0.830),and 0.883(95％CI 0.843～0.923),respectively,the sensitivity was 80.19％,77.36％,and 90.57％,and the specificity was 77.71％,75.80％,and 73.89％,respec-tively.The predictive value of serum miR-513a-5p combined miR-149-3p for patients with T2DM combined with osteoporosis was higher than that of individual diagnosis(Zcombination-miR-513a-5p=2.717,P=0.007,Zcombination-miR-149-3p=4.327,P＜0.001).Conclusion The expression levels of serum miR-513a-5p and miR-149-3p are reduced in patients with T2DM combined with osteoporosis.Ser-um miR-513a-5p and miR-149-3p are related to bone metabolism indicators and insulin resistance.The combination of the two has certain predictive value for patients with T2DM combined with osteoporosis.关键词
miR-513a-5p/miR-149-3p/2型糖尿病/骨质疏松症/骨代谢指标/胰岛素抵抗Key words
miR-513a-5p/miR-149-3p/type 2 diabetes mellitus/osteoporosis/bone metabolism indicators/insulin resist-ance分类
医药卫生
