HMGB1 and TLR4 as biomarkers for osteoporosis risk in type 2 diabetes mellitus: a cross-sectional study.

Background: This study explored the application value of high mobility group box 1 (HMGB1) and toll-like receptor 4 (TLR4) levels in the diagnosis of type 2 diabetes mellitus (T2DM) with osteoporosis (OP).

Methods: This was a cross-sectional study of 126 patients. The patients with T2DM was stratified into the following three subgroups: normal bone mass, osteopenia, and OP. Comparative analyses of general data and biochemical indices were performed, and Pearson's correlation was used to assess the relationship among HMGB1, TLR4 levels, and bone mineral density (BMD). Multivariate logistic regression identified risk factors in patients with T2DM. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of HMGB1 and TLR4 levels for OP in patients with T2DM.

Results: HMGB1 and TLR4 levels were significantly higher in the OP group than in the normal bone mass and osteopenia groups (p < 0.05). Pearson's correlation analysis revealed a negative association among BMD, HMGB1, and TLR4 levels. Multivariate logistic regression analysis identified Mg, HMGB1, and TLR4 as significant OP risk factors for T2DM. ROC curve analysis demonstrated that the areas under the curve for HMGB1 and TLR4 in predicting OP in patients with T2DM were 0.828 and 0.854, respectively, with respective sensitivities of 79.4% and 94.1% and respective specificities of 78.3% and 58.7%.

Conclusions: Serum HMGB1 and TLR4 levels may be potential biomarkers for OP in patients with T2DM.

Trial registration: Not applicable.