Analysis Of The Relationship Between Different Blood Glucose Levels And Bone Metabolic Indexes In Postmenopausal Women With Type 2 Diabetes Mellitus

Objective:To investigate the change trend in bone metabolism and fracture events in postmenopausal women with type 2 diabetes mellitus with different glycosylated haemoglobin levels（Hb A1c）and to analyze the correlation between glucose metabolism and bone metabolism and fracture events,to provide a theoretical basis for the early clinical diagnosis of osteoporosis in patients with type 2 diabetes mellitus and the risk of brittle fractures in patients with type 2 diabetes mellitus.Methods:Patients with type 2 diabetes treated in the Endocrinology Department of the first Hospital of Shanxi Medical University from September 2019 to January 2022 were selected strictly according to the inclusion and exclusion criteria.A total of 201postmenopausal T2DM female patients were selected and divided into three groups according to the Hb A1c test level at the time of admission,including 66 cases of Hb A1c≤6.5,69 cases of 6.5%<Hb A1c<9.0%and 66 cases of Hb A1c≥9.0%.The general data of the patients were collected,and the fracture history was recorded,and the glycosylated hemoglobin,fasting blood glucose,calcium,phosphorus,alkaline phosphatase,osteocalcin,N-terminal peptide of type I procollagen（P1NP）,25 hydroxyvitamin D（25（OH）D）,special sequence of carboxyl terminal peptideβof type I collagen（β-CTX）and parathyroid hormone（PTH）were measured.（1）according to Hb A1c level,postmenopausal T2DM female patients were divided into three groups:（1）Hb A1c level control group（Hb A1c≤6.5）,（2）Hb A1c level control group（6.5%<Hb A1c<9.0%）,and（3）Hb A1c control group（Hb A1c≥9.0%）.Compare the general data among the three groups,such as Ca²⁺,P^3-,ALP,OC,P1NP,25（OH）D,β-CTX,PTH,and whether there are statistically significant differences in fracture events;（2）analyze the correlation between serum Hb A1c and bone metabolic indexes and fracture events in postmenopausal T2DM female patients;（3）analyze the correlation between serum FBG and bone metabolic indexes and fracture events in postmenopausal T2DM female patients.Results:1.The higher the level of Hb A1c,the lower the levels of Ca²⁺,P^3-,25（OH）D,OC and PINP,the higher the levels ofβ-CTX and PTH,the lower the T value,and the higher the incidence of fracture.2.The level of Hb A1c was negatively correlated with Ca²⁺,P^3-,25（OH）D,OC and P1NP,and positively correlated withβ-CTX,PTH and fracture events.3.The level of FBG was negatively correlated with Ca²⁺,P^3-,25（OH）D,OC and P1NP,and positively correlated withβ-CTX and PTH.Conclusion:1.In postmenopausal T2DM patients,OC and P1NP decreased with the increase of Hb A1c and FBG levels,whileβ-CTX showed an upward trend and a positive correlation between them.2.In postmenopausal T2DM patients,the incidence of osteoporotic fracture increased with the increase of Hb A1c level,and there was a positive correlation between them.