Multiple Factors Analysis Changes Bone Mineral Density In Patients With Type 2 Diabetes Mellitus

OBJECTIVE The study is aimed to investigate the relation between changes in bone mineral density and contributory factors in patients with type 2 diabetes mellitus, and to explore the associations between the bone metabolism, immune and endocrine system.,so we can provide a new way to study and prevent the occurrence of osteoporosis.METHODS 88 patients with type 2 diabetes mellitus (DM group,48-82 years old ) and 36 healthy subjects (control group) were enrolled in the study . Two groups were matched in age ,sex and body mass index (BMI) . The levels of serum fasting blood glucose (FBG), serum fructosamine (GSP) , HbA1c , GPT , GOT ,TC , TG , BUN, Cr , S-Ca , S-P, U-Ca , U-P and TALP were measured by biochemical method ; osteocalcin (BGP) , PTH, E2, T were measured by RIA; NTX were detected by ELISA ; IgA , IgM, IgG by were assessed by immunofluorescence method; T lymphocyte were quantitated by flow cytometry ;and bone mineral (BMD) of lumbar spine and femur were detected by dual energy X-ray absorptiometry (DEXA) in all subjects . BMI was calculated according to the height and body weight . According to the results of BMD, the DM subjects were divided intoosteoporotic(OP) group and non-osteoporotic(NOP) group ,and various factors such as age ,course of disease, body mass index (BMI), sexual hormone, calcium et al, were correlated with BMD . In addition , all postmenopausal women in the DM group and control group were divided into four groups according to BMD, and we explore the immune changes in the postmenopausal osteoporosis. RESULTES1. The levels of BGP and BMD of DM group were significantly lower than that of control group, and the levels of NTX was significantly higher in DM group (P<0.05).2. The levels of BMD was positively correlated with BGP , E2 , T , and was negatively correlated with age ,duration, FBG, HbAlc ,GSP ,U-ca, U-p and NTX(P<0.05). There was no difference in S-Ca, S-P , BMI and immunoglobulin between DM group and control group .3. Abnormalities of the peripheral T lymphocyte subsets, especially those of CD4 and CD8 cells, CD4/CD8 ration were closely associationed with the decreased in bone mass in postmenopausal osteoporosis , and CD4/CD8 ration was negatively correlated with BMD (p<0.05).CONCLUSION1.Diabetes osteoporosis was characterized in low bone formation and high resorption, and was correlated with advanced age, poor metabolic control, low levels of E2,T, long history of diabetes mellitus et al.2. These results indicated abnormal of the peripheral T lymphocyte subsets and CD4/CD8 ration were closely associated with the decreased in bone mass in postmenopausal osteoporosis, supporting the causal relationship between T lymphocyte functions and the development of postmenopausal osteoporosis .