Association between serum ferritin and bone turnover marker levels in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease.

Postgraduate medicine Pub Date : 2024-04-01 Epub Date: 2024-03-25 DOI:10.1080/00325481.2024.2333718
Chongyang Chen, Yangting Zhao, Xiaoyu Lv, Kai Li, Yawen Wang, Dengrong Ma, Mei Han, Xiaohui Zan, Xinyuan Guo, Jingfang Liu
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Abstract

Objective: To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD).

Methods: Seven hundred and forty-two people with T2DM were selected. Serum bone turnover markers: osteocalcin (OC), type I procollagen N-terminal peptide (PINP), β-I type collagen carboxy-terminal peptide (β-CTx), and 25-hydroxyvitamin D3 (25-[OH]-D) levels were detected. High SF (HF) was defined as the indicated SF levels above 400 ng/mL in males and more than 150 ng/mL in females. Patients were divided into four groups: T2DM+normal SF (non-HF); T2DM+high SF (HF); T2DM+NAFLD+non-HF; andT2DM+NAFLD+HF. Relationships between SF and bone turnover markers were analyzed.

Results: Compared with the T2DM+non-HF group, β-CTx levels were higher in the T2DM+HFgroup. Compared with the T2DM+NAFLD+non-HF group, β-CTx levels were increased and 25-(OH)-D levels decreased in the T2DM+NAFLD+HF group (all p < 0.05). SF was positively correlated with β-CTx [β = 0.074; 95% CI (0.003, 0.205)] and negatively correlated with 25-(OH)-D [β=-0.108; 95%CI (-0.006, -0.001)]. Compared with the T2DM+non-HF group, an independent positive correlation was found between β-CTx and SF in the T2DM+NAFLD+HF group [OR = 1.002; 95% CI (1.001, 1.004)]. Among males, SF was positively correlatedwith β-CTx [β = 0.114; 95% CI (0.031, 0.266)]. SF was negatively correlated with 25-(OH)-D levels in both male and female patients [β=-0.124; 95% CI (0.007,0.001) and β=-0.168; 95% CI (-0.012, -0.002)]. Among those >50 years of age and postmenopausal females, SF was negatively correlated with 25-(OH)-D levels [β=-0.117; 95% CI (-0.007, -0.001) and β=-0.003; 95% CI (-0.013, -0.003)].

Conclusion: SF level was positively correlated with β-CTx in T2DM patients with NAFLD, which may promote bone resorption and increase the risk of bone loss.

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患有非酒精性脂肪肝的 2 型糖尿病患者血清铁蛋白与骨转换标志物水平之间的关系。
目的研究非酒精性脂肪肝(NAFLD)2 型糖尿病(T2DM)患者血清铁蛋白(SF)与骨转换指标的相关性。检测血清骨转换标志物:骨钙素(OC)、I型胶原蛋白N端肽(PINP)、β-I型胶原羧基端肽(β-CTx)和25-羟维生素D3(25-[OH]-D)水平。高SF(HF)的定义是男性SF水平超过400纳克/毫升,女性超过150纳克/毫升。患者被分为四组:T2DM+正常 SF(非 HF);T2DM+高 SF(HF);T2DM+NAFLD+非 HF;T2DM+NAFLD+HF。分析了SF与骨转换标志物之间的关系:与 T2DM+ 非 HF 组相比,T2DM+HF 组的β-CTx 水平更高。与 T2DM+NAFLD+non-HF 组相比,T2DM+NAFLD+HF 组的 β-CTx 水平升高,25-(OH)-D 水平降低(均为 50 岁以下绝经后女性,SF 与 25-(OH)-D 水平呈负相关[β=-0.117;95% CI (-0.007,-0.001) 和 β=-0.003;95% CI (-0.013,-0.003)]:非酒精性脂肪肝的 T2DM 患者的 SF 水平与 β-CTx 呈正相关,这可能会促进骨吸收并增加骨质流失的风险。
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