Study On The Relationship Between Islet β Cell Function And Bone Mineral Density In Patients With Type 2 Diabetes Mellitus

Objective:To investigate the relationship between isletβcell function and bone mineral density in patients with type 2 diabetes mellitus.Methods:405 cases of hospitalized T2DM patients were enrolled in this study,including 235 cases of male,female 170 cases.Collected from patients with age,height,weight,duration of disease,blood pressure,renal function,blood glucose,blood lipids and other biochemical indicators,all subjects underwent an oral glucose tolerance test or intravenous glucose tolerance test,using dual energy X-ray absorption meter determination of hip and lumbar spine bone mineral density.According to the bone density of patients,divided into normal bone mass group,osteopenia group and osteoporosis group.According to the age,divided into 2 groups:<50 years old age group and older than 50 years old.According to the group of patients with BMI were divided into 2 groups:normal weight group（<24kg/m²）,abnormal weight group（≥24 kg/m²）.Insulin resistance index HOMA-IR was used to evaluate insulin resistance,and HOMA-β,INS-AIR,CP-AUC,CP-AUC_180min80min and CPRI were used to evaluate the function of isletβcell secretion.Results:（1）To compare different bone density between groups,T2DM in osteoporosis group’s age and systolic blood pressure were higher than normal BMD group（P<0.05）,BMI,uric acid were lower than the normal bone mass group（P<0.05）.The duration of disease in osteopenia and osteoporosis groups were higher than that of normal group（P<0.05）.The basal insulin secretion of HOMA-βin osteopenia and osteoporosis groups were lower than that of normal group（P<0.05）.（2）Grouped according to gender,age,BMI,duration of disease and HOMA-IR,we found insulin resistance andβcell function were positively correlated with bone mineral density in different part of body in T2DM patients（P<0.05）.（3）Correlation analysis showed that the age of patients with T2DM L1-L4 of the lumbar spine,femoral neck and whole hip bone density was negatively correlated（P<0.05）;the duration of the disease was negatively correlated with BMD of the femoral neck and whole hip（P<0.05）;BMI and T2DM in patients with L1-L4 of the lumbar spine,femoral neck and whole hip bone density was positively correlated（P<0.05）;HOMA-IR of T2DM patients with femoral neck and whole hip bone mineral density was positively correlated（P<0.05）;HOMA-βwas positive correlation with bone density in L1-L4 patients with T2DM（P<0.05）.Further adjustment for age,duration of disease and BMI,CP-AUC_180min80min with whole hip’s BMD was positively correlated（P<0.05）,positively related to bone density in L1-L4 with AIR（P<0.05）.Conclusion:In patients with T2DM,the function of pancreatic beta cells is closely related to bone mineral density,the bone mineral density of patients with poor function of islet beta cell function is decreased,and improve the function of pancreatic beta cells can enhance bone mineral density of T2DM patients.