The Correlation Analysis Of Urinary Microalbumin And Bone Metabplism Markers And Bone Mineral Density In Male Patients With Type 2 Diabetes Mellitus

Objective:To investigate the relationship between urinary microalbumin and bone metabolism markers and bone mineral density（BMD）in male with type 2 diabetes mellitus patients.Methods:We selected 115 male patients with type 2 diabetes mellitus（T2DM）admitted to the endocrinology department of XXX from December2018 to November 2020,According to the standard of diabetic kidney disease（DKD）,based in urinary microalbumin creatinine ratio（UACR）,62 cases in normal group,31 cases in microalbuminuria group,22 cases in macroalbuminuria group,and collected the following data for One-way ANOVA analysis:age,duration of diabetes,smoking index,alcohol intake,body mass index（BMI）,fasting plasma glucose（FPG）,Homeostasis model assessment of insulin resistance（HOMA-IR）,Homeostasis model assessment ofβ-cell function（HOMA-β）,glycosylated hemoglobin A1c（Hb A1c）,fructosamine（FA）,serum creatinine（Cr）,testosterone（T）,estradiol（E₂）,calibrating serum calcium（Cs Ca）,serum phosphorus（P）,serum alkaline phosphatase（ALP）,serum albumin（ALB）,total 25-hydroxyvitamin D（25（OH）D）,intact parathormone（i PTH）,osteocalcin（OCN）,β-carboxy peptide（β-CTX）,total type I procollagen N propeptide（P1NP）,UACR and Lumbar bone mineral density（BMD）L1-L4,Pearson correlation analysis was performed for UACR level and bone mineral density and bone metabolism indexes and logistic regression was used to analyze the factors affecting bone mass abnormality in T2DM patients.Results:1.There were no significant differences in smoking index,alcohol intake,BMI,FPG,HOMA-IR,HOMA-β,Hb A1c,FA,T,E₂,BMD-L2,BMD-L3,BMD-L4,Cs Ca,P,total P1NP,OCN and ALP among the three groups（P>0.05）.2.There were significant differences in age,the duration of diabetes,Cr,β-CTX and i PTH among the three groups（P<0.05）,which were the highest in the large albuminuria group and the lowest in the normal group.And there were significant differences in ALB,total 25（OH）D,lumbar mean BMD and BMD-L1 among the three groups（P<0.05）,which were the highest in the normal group and the lowest in the large amount of proteinuria group.3.Correlation analysis:（1）There was no correlation between mean BMD and UACR（P>0.05）;（2）There was no correlation between mean BMD and i PTH,Cs Ca,P and ALP（P>0.05）;Mean BMD was correlated with total 25（OH）D,β-CTX,P1NP and OCN（r=0.197,r=-0.32,r=0.197,r=0.602,P<0.05）;（3）There was no correlation between UACR andβ-CTX,P1NP,OCN,Cs Ca,P and ALP（P>0.05）,but there was correlation between UACR and total 25（OH）D and i PTH（r=-0.434,r=0.187,P<0.05）;（4）In the large proteinuria group,Mean BMD,P1NP and OCN were negatively correlated with UACR（r=-0.931,r=-0.808,r=-0.931,P<0.05）,β-CTX and i PTH were positively correlated with the UACR（r=0.65,r=0.893,P<0.05）.4.Logistc regression analysis:UACR,total 25（OH）D,β-CTX,total P1NP and OCN were the influencing factors of male T2DM patients with abnormal bone mass.Conclusions:1.In male T2DM patients,with the increase of UACR,the progression of nephropathy,the decrease of bone mass and BMD,and the increase of OP risk.2.DKD patients are more likely to suffer from mixed renal bone disease than T2DM patients alone.3.DKD patients are at risk of reduced bone formation and increased bone resorption,and monitoring UACR,25（OH）D and BTMs has certain value in assessing the risk of renal damage and associated bone mass abnormality in T2DM patients.4.The early stage of nephropathy is the transition period of bone metabolism,and early intervention of DKD is more significant for the prevention and treatment of the occurrence and development of OP.