BMP-2、Galectin-3、COMP水平对老年2型糖尿病合并骨关节炎的预测价值

doi:10.3969/j.issn.1006-5725.2026.09.016

Abstract

Abstract:

Objective To explore the high-risk factors of senile type 2 diabetes complicated with osteoarthritis， as well as the levels of bone morphogenetic protein-2 （BMP-2）， Galectin-3， and cartilage oligomeric matrix protein （COMP）. Methods The study subjects were selected from elderly patients with type 2 diabetes who were admitted to our hospital during the enrollment period from June 2022 to June 2025. A total of 370 cases were included. Based on whether the selected patients were complicated with osteoarthritis， they were divided into the combined group （163 cases） and the non-combined group （207 cases）. The clinical data， as well as the levels of BMP-2， Galectin-3， and COMP， of the two groups were compared. Multivariate Logistic regression analysis was employed to analyze the risk factors of elderly type 2 diabetes complicated with osteoarthritis. The receiver operating characteristic （ROC） curve was utilized to analyze the predictive value of serum BMP-2， Galectin-3， and COMP for elderly type 2 diabetes with osteoarthritis. Moreover， the regression equation of serum BMP-2， Galectin-3， and COMP in predicting elderly type 2 diabetes patients with osteoarthritis was constructed. The levels of BMP-2， Galectin-3， and COMP under different disease conditions were compared. Results The proportions of females， individuals with a smoking history， and those with hypertension in the combined group were higher than those in the non-combined group. The combined group was older and had a longer duration of type 2 diabetes （P < 0.05）. The level of serum BMP-2 in the combined group was lower than that in the non-combined group， while the levels of serum Galectin-3 and COMP were higher than those in the non-combined group （P < 0.05）. Multivariate logistic regression analysis showed that being female， having a smoking history， having hypertension， being of an older age， having a long duration of type 2 diabetes， having a low level of serum BMP-2， having a high level of serum Galectin-3， and having a high level of serum COMP were independent risk factors for elderly type 2 diabetes with osteoarthritis （OR = 3.043， 3.758， 2.680， 2.472， 2.155， 2.578， 2.375， 2.010， P < 0.05）. A regression equation was constructed： logit （P）= - 8.012 + sex × 1.113 + smoking history × 1.324 + hypertension × 0.986 + age × 0.905 + type 2 diabetes duration × 0.768 + serum BMP-2 level × 0.947 + serum Galectin-3 level × 0.865 + serum COMP level × 0.698. The construction of a logistic multiple regression diagnostic equation is effective. Based on the diagnostic probability logit （P）， an ROC curve was plotted to predict elderly patients with type 2 diabetes and osteoarthritis. When logit （P） > 0.246， the area under the curve （AUC） value was 0.884， the 95% confidence interval （CI） was 0.847 - 0.915， and the χ² value was 22.578. The diagnostic sensitivity and specificity were 82.21% and 80.19%， respectively. The AUC of serum BMP-2， Galectin-3， COMP， and combined detection for predicting elderly patients with type 2 diabetes and osteoarthritis were 0.793， 0.721， 0.792， and 0.843， respectively. The diagnostic sensitivities were 72.39%， 72.39%， 73.62%， and 91.41%， respectively， and the specificities were 73.91%， 62.32%， 77.29%， and 66.18%， respectively. The AUC of the combined detection was the highest （P < 0.05）. The level of serum BMP-2 in the severe group was lower than that in the mild and moderate groups， and the level in the moderate group was lower than that in the mild group. The levels of serum Galectin-3 and COMP in the severe group were higher than those in the mild and moderate groups， and the level in the moderate group was higher than that in the mild group （P < 0.05）. Conclusions Female gender， a history of smoking， hypertension， advanced age， a long duration of type 2 diabetes， a low level of serum BMP-2， a high level of serum Galectin-3， and a high level of serum COMP were identified as independent risk factors for type 2 diabetes accompanied by osteoarthritis in the elderly. Serum BMP-2， Galectin-3， and COMP were， to some extent， associated with the severity of osteoarthritis. They could be utilized for the auxiliary diagnosis of the onset of type 2 diabetes complicated by osteoarthritis in the elderly and the assessment of osteoarthritis. The combined detection of these three markers had the highest predictive value for type 2 diabetes complicated by osteoarthritis in the elderly.

Key words: old age, type 2 diabetes, osteoarthritis, high risk factors, bone morphogenetic protein-2, galectin-3, oligomeric matrix protein of cartilage

CLC Number:

R181.3

Ying WANG,Guyue ZHANG,Hui WANG,Suya SUN,Fengfei WANG,Ge ZHANG. The predictive value of BMP-2， Galectin-3 and COMP levels for elderly patients with type 2 diabetes mellitus complicated with osteoarthritis[J]. The Journal of Practical Medicine, 2026, 42(9): 1610-1616.

Figures/Tables 7

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References 21

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项目	合并组（n = 163）	未合并组（n = 207）	t/χ²值	P值
性别/[例（%）]			20.863	< 0.001
男	43（26.38）	103（49.76）
女	120（73.62）	104（50.24）
年龄/岁	81.32 ± 3.98	80.51 ± 2.99	2.235	0.026
BMI/（kg/m²）	24.01 ± 0.98	23.85 ± 0.86	1.670	0.096
2型糖尿病病程/年	16.98 ± 2.54	14.02 ± 2.29	11.762	< 0.001
吸烟史/[例（%）]			8.990	0.003
有	49（30.06）	35（16.91）
无	114（69.94）	172（83.09）
高血压/[例（%）]			14.636	< 0.001
有	98（60.12）	83（40.10）
无	65（39.88）	124（59.90）
高尿酸血症/[例（%）]			0.001	0.973
有	8（4.91）	10（4.83）
无	155（95.09）	197（95.17）
维生素D缺乏症/[例（%）]			0.132^*	0.716
有	5（3.07）	4（1.93）
无	158（96.93）	203（98.07）
使用降糖药情况/[例（%）]			0.981	0.322
有	124（76.07）	148（71.50）
无	39（23.93）	59（28.50）
血清餐后2 h血糖水平/（mmol/L）	11.77 ± 3.01	11.57 ± 2.68	0.675	0.500
血清甘油三酯水平/（mmol/L）	1.81 ± 0.41	1.75 ± 0.33	1.560	0.120
血清总胆固醇水平/（mmol/L）	4.44 ± 0.34	4.38 ± 0.27	1.892	0.059
血清高密度脂蛋白胆固醇水平/（mmol/L）	1.93 ± 0.32	1.96 ± 0.41	0.768	0.443
血清低密度脂蛋白胆固醇水平/（mmol/L）	4.12 ± 1.05	3.97 ± 0.98	1.416	0.158
血清总胆红素水平/（mmol/L）	9.01 ± 0.99	8.85 ± 0.84	1.681	0.094

指标	合并组（n = 163）	未合并组（n = 207）	t值	P值
血清BMP-2水平/（ng/L）	9.02 ± 1.06	10.98 ± 1.56	13.735	< 0.001
血清Galectin-3水平/（pg/mL）	1 311.23 ± 240.65	1 139.76 ± 199.82	7.486	0.002
血清COMP水平/（μg/L）	4.48 ± 0.48	3.82 ± 0.27	16.712	< 0.001

因素	变量性质	赋值
骨关节炎	Y	0 =无，1 =有
性别	X₁	0 =男，1 =女
吸烟史	X₂	0 =无，1 =有
高血压	X₃	0 =无，1 =有
年龄	X₄	原值输入
2型糖尿病病程	X₅	原值输入
血清BMP-2水平	X₆	原值输入
血清Galectin-3水平	X₇	原值输入
血清COMP水平	X₈	原值输入

变量	β	SE	Waldχ²	P值	OR	95%CI
女性	1.113	0.436	6.517	0.011	3.043	1.295 ~ 7.153
有吸烟史	1.324	0.365	13.158	< 0.001	3.758	1.838 ~ 7.686
有高血压	0.986	0.437	5.091	0.024	2.680	1.138 ~ 6.312
年龄	0.905	0.398	5.170	0.023	2.472	1.133 ~ 5.393
2型糖尿病病程	0.768	0.287	7.161	0.007	2.155	1.228 ~ 3.783
血清BMP-2水平	0.947	0.341	7.712	0.005	2.578	1.321 ~ 5.030
血清Galectin-3水平	0.865	0.373	5.378	0.020	2.375	1.143 ~ 4.934
血清COMP水平	0.698	0.265	6.938	0.008	2.010	1.196 ~ 3.378

指标	截断值	AUC	敏感度/%	特异度/%	P值	95%CI
血清BMP-2水平	10.07 ng/L	0.793	72.39	73.91	< 0.001	0.748 ~ 0.833
血清Galectin-3水平	1 194.18 pg/mL	0.721	72.39	62.32	< 0.001	0.672 ~ 0.766
血清COMP水平	4.14 μg/L	0.792	73.62	77.29	< 0.001	0.747 ~ 0.832
联合检查	-	0.843^abc	91.41	66.18	< 0.001	0.802 ~ 0.878

The predictive value of BMP-2， Galectin-3 and COMP levels for elderly patients with type 2 diabetes mellitus complicated with osteoarthritis

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指标	轻度组（n = 49）	中度组（n = 73）	重度组（n = 41）	F值	P值
血清BMP-2水平/（ng/L）	10.02 ± 1.21	9.11 ± 1.03^d	7.68 ± 0.92^de	50.602	< 0.001
血清Galectin-3水平/（pg/mL）	1 183.43 ± 228.54	1 287.23 ± 239.54^d	1 506.71 ± 257.09^de	20.763	0.002
血清COMP水平/（μg/L）	3.91 ± 0.34	4.52 ± 0.56^d	5.08 ± 0.51^de	63.938	< 0.001

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