In this study, we aimed to describe the role of bone-derived factor (osteocrin) in glucose metabolism, micro and macrovascular complications in diabetic patients. Thus, further investigations of the endocrine system through bone-derived hormones may provide as new perspectives on the prediction, prevention, and treatment of diabetes mellitus.

Diabetes mellitus (DM) remained the most common metabolic disorder worldwide occupying the 8th leading cause of death.[1] Defining new predictive biomarkers in diabetes would provide a window of opportunity for preventive and/or therapeutic interventions to prevent or delay the onset of irreversible long-term micro and or macro vascular complications. Progressive micro vascular vaso-degeneration is the major factor in progression of diabetic complications and contribute greatly to the increased mortality and morbidity. [2] Where Hemodynamic-mediated vascular injury was considered as one mechanism in the pathogenesis of diabetic nephropathy. [3] Bone disorders have been drawing attention as a novel diabetic complication, and diabetes is associated with an increased risk of osteoporotic fracture [4-6]. Bone is considered as an endocrine organ that influences various organs and tissues via the secretion of multiple bone derived hormones [7-8]. These endocrinal functions are, for example, glucose homeostasis [9], appetite control [10], fat deposition [11], skeletal muscle adaptation [12], male fertility [13], and cognition [14].

Therefore, these bone-derived hormones can become useful biomarkers for predicting the incidence of diabetes and the progression of diabetic complications. Osteocrin (OSTN), a bone-derived humoral factor, is a small secreted peptide cloned from bone and muscle complementary DNA (cDNA) libraries [15]. Osteocrin (Ostn) is secreted protein produced by cells of the osteoblast lineage that shows a well conserved homology with members of the natriuretic peptide (NP) family with prohormone-like characteristics [17]. To date, the exact role of Ostn has not been elucidated.

In this study, we aimed to describe the role of bone-derived factor (osteocrin) in glucose metabolism, micro and macrovascular complications in diabetic patients. Thus, further investigations of the endocrine system through bone-derived hormones may provide as new perspectives on the prediction, prevention, and treatment of diabetes mellitus.

Inclusion Criteria:

- Cases of the study will select randomly, based on inclusion criteria that included

• Patients were diagnosed with diabetes mellitus according to American Diabetes Association
• Age range 20-70 years
• No apparent vascular abnormalities and Acute complications

Exclusion Criteria:

• Patients are excluded for participation in the study if

  • Patients had past history of cardiovascular events (heart failure or history of coronary artery disease),
  • infections,
  • aacute diabetic complications,
  • diabetic patients on regular hemodialysis .
  • acute illness, malignancy, or pregnancy.

the estimated minimum required sample size is 90 patients ( 45 patients in type 1 and 45 patients in type 2).