Serum Osteocalcin as a Risk Factor for osteosarcopenia in elderly patients with T2DM

Abstract Background Osteosarcopenia(OS) has become a global public health problem, which highly influence the life quality for the elderly patients with type 2 diabetes mellitus (T2DM). However, the diagnostic processes is complex and difficult due to lack of the exact diagnostic biomarker. Thus, it is necessary to screen the sensitive biomarker of musculoskeletal metabolism in older patient with T2DM. Previous studies have suggested that osteocalcin mainly involved into the development of musculoskeletal metabolism. This study aimed to investigate the relationship between osteocalcin and osteosarcopenia in elderly patients with T2DM. Methods Here we designed a cross-sectional study that included 224 elderly patients with T2DM. We collected the general data and experimental indexes of those patients including bone mineral density (BMD), skeletal muscle index (SMI), grip strength, and gait speed were measured. All subjects were divided into 5 groups based on the above indicators: Controls (CO), Pre-osteosarcopenia(P-OS),Sarcopenia (SP), Osteoporosis(OP), Osteosarcopenia (OS).Meanwhile we examined several bone metabolism-related indexes such as osteocalcin (OC), β-collagen special sequence (β-CTX), and type I procollagen N-terminal propeptide (PINP). Logistic regression analysis was used to analyze the relationship between osteoscarsopenia and osteocalcin. Results The results showed the levels of OC, β-CTX, and PINP increased in the osteosarcopenia group. BMD, SMI, handgrip strength and calf circumference decreased with the increasing osteocalcin concentrations (p < 0.05). A higher serum osteocalcin level was associated with higher risk of OS (OR = 10.84, 95% CI (1.24-95.00)) in the logistic regression model. Conclusion Osteocalcin might be used as the important biomarker to predict the risk of OS in elderly type 2 diabetes.