Osteocalcin serum levels in obese patients with type 2 diabetes mellitus: The virtual points observed in a case control study

To elucidate the effect of metformin alone or in combination with sitagliptin on osteocalcin serum levels in obese patients with type 2 diabetes mellitus (T2DM). This case-control study was conducted at the Department of Clinical Pharmacology and Therapeutic, College of Medicine, Mustansiriyah University, Baghdad, Iraq, from February to April, 2019. This study comprised 62 obese T2DM patients compared with 28 healthy controls, they were divided into three groups; Group I: Obese patients with T2DM on metformin (n=36), Group II: Obese patients with T2DM on metformin plus sitagliptin (n=26), and Group III: healthy controls subjects (n=28). Body mass index (BMI), blood pressure profile, lipid profile, Glycaemic indices, and serum levels of human osteocalcin were measured. The data analysis was done by using SPSS 20. Osteocalcin serum level was lower in patients with T2DM compared with the control (P=0.001), also it was relatively low in metformin (MT) group (21.04±3.16 ng/mL) compared to sitagliptin (ST) group (25.65±7.30 ng/mL), (P=0.04). In relation to the HbA1c, osteocalcin serum level was reduced in patients with T2DM with high HbA1c (HbA1c-H) compared to the patients with T2DM with low HbA1c (HbA1c-L), (P=0.03) and was not significantly different when compared with moderate HbA1c (HbA1c-M), (P>0.05). However, osteocalcin was negatively correlated with HOMA-IR(r=-0.78, P=0.0001). Osteocalcin serum level was reduced in T2DM patients and negatively correlated with HOMA-IR and HbA1c and FBG. Combination of metformin with sitagliptin was more effective than metformin monotherapy in amelioration of osteocalcin serum level in patients with T2DM.