Study On The Relationship Between Sarcopenia And Bone Mineral Density In Elderly Type 2 Diabetic Patients In Qinghai Area

Objective:1.By observing the muscle mass and bone mineral density(BMD)levels of middle-aged and elderly patients with type 2 diabetes mellitus(T2DM)in Qinghai area,to explore whether there is any difference in BMD between T2 DM group and non-T2 DM group and related factors.2.To study the prevalence and risk factors of sarcopenia and osteoporosis in middle-aged and elderly T2 DM population in Qinghai area,so as to carry out early intervention and treatment.Methods:In this study,130 middle-aged and elderly patients diagnosed with T2 DM in Qinghai Provincial People’s Hospital from September 2020 to October 2021 were selected as the research objects.Muscle mass,bone mineral density,grip strength and walking speed of the patients were measured.According to the diagnosis criteria of sarcopenia agreed by experts in 2019 Asian Sarcopenia Working Group,The subjects were divided into a sarcopenia group(29 cases)and a non-sarcopenia group(101 cases),To compare the differences in general data,bone mineral density and biochemical parameters between the two groups,and the correlations between BMD and ASM,ASMI,grip strength,walking speed and body fat were observed through correlation analysis.Risk factors of sarcopenia and osteoporosis in middle-aged and elderly T2 DM patients in Qinghai area were further analyzed.Results:1.Among 130 middle-aged and elderly T2 DM patients in this study,the positive rate of sarcopenia,osteoporosis and bone loss was 22.3%,16.2% and 33.1%respectively.The detection rate of sarcopenia combined with osteoporosis was7.69%.2.The BMD of lumbar vertebra and left and right femoral neck in sarcopenia group were significantly lower than those in non-sarcopenia group(P<0.05),the prevalence of osteoporosis in sarcopenia group and non-sarcopenia group was 34.5%and 10.9%,respectively,and the difference was statistically significant(P=0.002).Correlation analysis showed that ASMI was significantly positively correlated with the bone mineral density of lumbar vertebra,bone mineral density of left and right femoral neck(r=0.569,0.488,0.514,P<0.05);3.Logistic regression analysis showed that sarcopenia and osteoporosis were risk factors for each other.In middle-aged and elderly T2 DM patients,the duration of diabetes(OR=1.087,P<0.05)and osteoporosis(OR=3.740,P<0.05)were risk factors for sarcopenia,and BMI(OR=0.783,P<0.05)was a protective factor for sarcopenia.Female(OR=5.754,P<0.05),sarcopenia(OR=4.768,P<0.05)was a risk factor for osteoporosis,and insulin resistance index(OR=0.500,P<0.05)were protective factors of osteoporosis.Conclusions:1.The prevalence of sarcopenia and osteoporosis in middle-aged and elderly T2 DM patients in Qinghai area is high,health education should be conducted to popularize relevant knowledge,and early screening of sarcopenia and osteoporosis in T2 DM patients.2.Sarcopenia is closely related to osteoporosis as a risk factor.Among them,ASMI,grip strength,walking speed and bone mineral density of T2 DM patients are positively correlated,and ASMI can be used as an important indicator for preliminary prediction of bone mineral density decline and osteoporosis.In places where it is difficult to measure ASMI and bone mineral density,grip strength and walking speed can be used as convenient and easy to measure indicators for early screening of sarcopenia and osteoporosis.3.Vitamin D level of T2 DM patients in Qinghai area is generally deficient,so early life intervention should be given,and long-term vitamin D supplementation should be provided if necessary.