| Background and Objective:Diabetic osteoporosis(DOP)is one of the most common chronic complication of diabetes mellitus(DM).It is also one of the causes of chronic severe pain and dysfunction of the body in diabetic patients.Data from epidemiological survey showed that the risk of fracture in diabetic patients was significantly higher than that of the general population.At present,it is well known that there is a low bone mass in type 1 diabetics which closely related to osteoporosis.However,it is still controversial to the relationship between type 2 diabetes and osteoporosis.Previous studies shown that the bone mineral density in type 2 diabetics was normal,yet the risk of fracture was in high level in real world for type 2 diabetics.The study was designed to explore the relationship between the status of bone metabolism in type 2 diabetics with different levels of glycemic controlled.Subjects and Methods:A retrospective and real-world analysis method were used.Ninety male patients with type 2 diabetes mellitus who met the inclusion criteria come from outpatient and inpatient of the First Affiliated Hospital of Guangzhou Medical University,from December 2011 to March 2016 were included in the analysis.The patients were divided into 3 groups according to the Hemoglobin A1c(HbA1c)levels.,which was group A(HbA1c≥9%,N = 30),group B(HbA1c7 ~ 9%,N = 30)and group C HbA1c≤7%,N = 30).Thirty healthy age-matched males(group D)which took physical examination at the same time were involved into the control group.Their levels of serum bone metabolic biochemical markers,including procollagen 1 N-terminal peptide(P1NP),β C-terminal telopeptide of type 1 collagen(β-CTX),and 25-hydroxy vitamin D[25(OH)VD],etc were detected respectively.The relationship between glucose metabolic and bone metabolic in the four groups were analyzed.Statistical software of SPSS19.0 version was used.All data run the normality test.The data that follow a normal distribution were expressed as means±SD and analyzed by independent t test or one-way ANOVA.Pearson analysis was used to judge the correlation between HbA1 c and the serum bone biochemical markers such as P1 NP,β-CTX,25(OH)VD,etc.P value<0.05 was considered being significantly difference.Results:1.There was no difference among the four groups in age,systolic blood pressure,diastolic blood pressure,BMI,function of liver and kidney,serum calcium and phosphorus,PTH,urinary albumin and bone mineral density(P>0.05).2.Compared to the D group:2.1 The levels of 25(OH)VD were significantly lower in group A,B and C [(9.4 ± 2.3)mmol/l vs(22.6 ± 6.3)mmol/l,(13.3 ± 3.1)mmol/l vs(22.6 ± 6.3)mmol/l,(15.2 ± 4.3)mmol/l vs(22.6 ± 6.3)mmol/l,respectively,P <0.05];2.2 The levels of P1 NP were significantly lower in group A,B and C [(42.2 ± 8.4)mmol/l vs(71.3 ± 7.3)mmol/l,(46.3 ± 9.3)mmol/l vs(71.3 ± 7.3)mmol/l,(51.2 ± 14.3)mmol/l vs(71.3 ± 7.3)mmol/l,respectively,P <0.05];2.3 The levels of β-CTX in group A,B and C were significantly higher than those in group D[(0.9 ± 0.1)mmol/l vs(0.3 ± 0.1)mmol/l,(0.8 ± 0.1)mmol/l vs(0.3 ± 0.1)mmol/l,(0.6 ± 0.1)mmol/l vs(0.3 ± 0.1 mmol/l),respectively,P <0.05]3.Correction analysis showed that with the increasing of HbA1 c level,the levels of [25(OH)VD] and P1 NP decreased significantly in group A,B and C(P<0.05);yet the levels of β-CTX significantly increased in those three groups(P <0.05).Conclusions:1.Compared to the healthy males,male-patients with type 2 diabetics showing abnormal status of bone metabolism,including worse vitamin D nutritional status and more active bone resorption status.2.There are significant differences in bone metabolic status between diabetic patients with different levels of glycemic control,which showing that the worse of the blood glucose controlled,the lower of the serum 25-hydroxy vitamin D level,and the more active of the bone resorption status. |
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