The Changes Of Bone Mineral Density In Type 2 Diabetic Patients And The Analys Of The Correlated Factors

Objective:To investigate the changes of bone mineral density in the patients with type 2 diabetes mellitus and to study the morbidity and related factors of osteopenia in the patients with T2DM.Methods:BMD of lumbar vertebrae of 68 hospitalized type 2 diabetic patients and 68 non-diabetic subjects matched with age,BMI and sex were measured with dual energy X-ray absorptiometry(DEXA). Mean age of the patients is (55.41±11.55) yr, BMI is(24.14±2.540)kg/m2,and among the total there are 30 females and 38 males.Mean age of the heathy subjects is (56.01±8.698)yr, BMI is(24.97±2.936)kg/m2,and among the total there are 29 females and 39 males.Patients with T2DM are divided into group A(osteopenia )and group B(normal).Osteopenia were defined as BMD below -1 SD peak BMD in the same sex (T score). And the fasting plasma glucose (FPG) , HbA1c, blood calcium (Ca), blood phosphor (P), ALP, cholesterin(chol), triglyceride (TG), Cr and BUN were also detected in diabetic patients.In the same time, the patients with T2DM undertook the examination of fundus,the color doppler ultrasonography of great vessel(arteria carotis or Artery of lower extremity ) and the check of peripheral neuropathy. All the data and the correlation between BMD and those factors was analysed statistically.Results:1.The prevalence rates of osteopenia were 38.24%and 27.94% in diabetic and control groups respectively(P <0.05). The BMD of L2- 4 were (1.117±0.220)kg/m2 and(1.186±0.185 ) kg/m2in diabetic and control group respectively (P <0.05).Compared with control group, the BMD of L2-4 in diabetic patients significantly decreased .2. There was significantly statistical difference in age, course , HbA1c,BMI,FBG between Group A and Group B (P<0.05). Multivariate regression analysis showed that BMD of diabetic patients negatively correlated with age , course , HbA1c and positively correlated with BMI.3. The prevalence rates of arterial sclerosis were 80.77%and 50% in group A and group B respectively(P<0.05),while the prevalence rates of retinopathy were 50% and 28.57%(P>0.05),the prevalence rates of peripheral neuropathy were 69.23% and 45.24%(P>0.05).Conclusions:1.The prevalence rates of osteopenia in the patients with T2DM are higher than control group, BMD also significantly decreases compared with control group. A patient with type 2 diabetes mellitus was prone to occur osteopenia.2.Aging, long disease course, low bodyweight and poor glycemic control are risks of low BMD in type 2 diabetes.3. The prevalence rates of arterial sclerosis in group A was higher than that in group B significally,which shows Type 2 diabetes mellitus might reduce BMD which is closely correlated with DM'S arterial sclerosis.The prevalence rates of retinopathy and the risk of peripheral neuropathy in group A were higher than that in group B,but not statistically significant,whether it is true needs further study.4. In order to prevent osteopenia , lower the risk of bone fracture and improve the life quality , it is helpful for patients with T2DM to strictly control blood glucose level ,BMI, complication and take BMD examination regularly.