Changes In Bone Metabolism Markers And Bone Mineral Density In Male Patients With Type 2 Diabetic Nephropathy

Objective:(1) The change of BMD and bone metabolism markers were observed in male patients with DN.(2) Bone metabolism markers helps to found abnormal bone mass earlier of DN patients, active intervention to reduce the risk of fracture.Methods:98 male patients with type 2 diabetes mellitus(T2DM))(including diabetic nephropathy) were choosed from February 2015 to July 2015,who were treated in Department of Endocrinology in the Second Hospital of Shanxi Medical University,according to the staging of diabetic nephropathy and 24-hour urinary albumin level quantitation, the T2 DM patients were divided into three groups : DM group:34 cases,early DN group:32 cases, clinical DN group:32cases; patient blood biochemistry, BMD and bone metabolism markers for comparison analysis.Results:Compared with the DM group, in clinical DN group, serum calcium levels were significantly decreased, the difference was statistically significant(P <0. 05). Different stages of DN groups were compared, the osteocalcin(BGP), total Ⅰ procollagen amino-terminal extension of a peptide(T-PINP), 25-hydroxy vitamin D(25-OH-D3)levels decreased gradually, Ⅰcollagen carboxy-terminal peptideβspecial sequence(βCTX) and parathyroid hormone(PTH) levels were gradually rising, and the differences were statistically significant(P <0.05). Three lumbar spine and hip bone mineral density decreased gradually, the differences were statistically significant(P <0.05). The bone mineral density of clinical DN group was positively correlated with serum calcium, BGP,T-PINP, and PTH was negatively correlated(P <0.05). Three groups were positively correlated with BMD 25-OH-D3, the correlation coefficient were 0.454,0.565,0.674.Among them, 25-OH-D3, BGP have the highest correlation with BMD.Conclusions:1、With the progress of male patients with DN, bone loss were increased significantly,bone mineral density were decreased, the risk of fractures and mosteoporosis were increased.2 、 Bone metabolism markers are more sensitive to reflect the changes of bone metabolism in early stage of DN than BMD, and 25-OH-D3 and BGP are predictors in DN patients with osteoporosis.