QCT Bone Mineral Density And Its Influencing Factors In Patients With Type 2 Diabetes Mellitus

Objectives: Comparing patients with T2DM(Type 2 Diabetes Mellitus)with healthy controls of the same age with normal glucose tolerance and BMI,QCT(Quantitative Computed Tomography)was used to detect the difference of volume bone mineral density and abdominal fat distribution.The consistency of QCT and DXA in the diagnosis of osteoporosis was evaluated,and the related influencing factors that might lead to the difference in the diagnosis of osteoporosis were further analyzed.The effects of T2 DM course,family history of diabetes mellitus,related complications,insulin use or not on the changes of bone mineral density and the changes of related biochemical indexes were analyzed.Methods: The interviewees were inpatients in the Department of Endocrinology who met the screening requirements from June 2019 to January 2021 in our research group "Study on Changes in QCT Bone Mineral Density and Its Influences in Patients with Type 2 Diabetes",including 35 female patients with T2 DM in postmenopausal period and 37 male patients over 40 years old.In the normal control group,there were 26 postmenopausal women and 48 men over 40 years old.Statistical methods were used to analyze the effects of age,gender,height,weight,BMI,abdominal fat distribution,disease course,related complications,insulin use or not on the change of bone mineral density and the changes of related biochemical indexes.Statistical t test was used for the measurement data conforming to normal distribution,rank sum test was used for the measurement data non-normal distribution,and chi-square test was used for the analysis of the classification variables.Bivariate correlation analysis of measurement data was performed using Pearson correlation(normal)and Spearman correlation(non-normal).Kappa values were used to evaluate the diagnostic consistency of QCT and DXA(Dual Energy X-Ray Ababsorptiometry).p<0.05 indicates that the difference is statistically significant.Results: Visceral Adipose Tissue/Total Adipose Tissue(Visceral Adipose Tissue/Total Adipose Tissue)in T2 DM patients were significantly higher than those in normal controls(p < 0.05).There was no significant difference in QCT-VBMD between the two groups(p>0.05).For postmenopausal women with T2 DM,both QCT-VBMD(r=-0.474,p=0.004)and DXA area BMD(DXA-BMD)(r=-0.355,p=0.036)were negatively correlated with age regarding changes in lumbar vertebral bone density.The sensitivity of QCT to abnormal bone mass was significantly better than that of DXA.The detection rate of abnormal bone mass was 61.2% for QCT and 34.57% for DXA.Kappa=0.329<0.4,p=0.003.Comparison of QCT and DXA assessment of abnormal bone mass: consistent diagnosis VS inconsistent diagnosis related indicators,TG(Triglyceride)(p=0.035),VAT(p=0.045),VAT/TAT(p=0.049)in the group with inconsistent diagnosis were significantly higher than those in the group with consistent diagnosis.Logistic regression analysis showed that TG,VAT/TAT were positive independent influencing factors for diagnosis inconsistency(p<0.05).Conclusions: The visceral fat accumulation rate(VAT/TAT)in T2 DM patients was higher than that in healthy controls.Age is a negative influencing factor for BMD reduction in postmenopausal women with T2 DM.Visceral fat accumulation may be one of the reasons for the lower detection rate of abnormal bone mass of DXA than that of QCT.Moreover,TG can be used to predict the inconsistency between QCT and DXA.Clinicians can evaluate patients’ DXA results based on the TG results of patients,and decide whether further improvement of QCT-VBMD and abdominal fat distribution results should be taken as supplements.