Effects Of Exogenous Insulin On Bone Mineral Density And Some Of Bone Metabolism Biochemical Markers In Patients With Type 2 Diabetes Mellitus

Objective: To explore the effect of insulin on the BDM and some of bone metabolism biochemical markers in type 2 diabetic patients and the relative risk factors.Methods: 547 type 2 diabetic patients including 188 patients(male 95, female 93,) who treated with oral hypoglycemic agents (Group B) and 349 patients(male 179;female 160) with insulin ( Group C) were recruited in the study. Group C was divided into four subgroups depending on the time of insulin treatment: Group C1, within0-1year (male 50, female 48); Group C2, within1-5years(male 49, female 51)Group C3, within1-5years(male 42,female 41); Group C4, (male 38, female 40). BMD levels, HbA1c, FBG,BGP,CT,Ca, P and ALP were measured in the two groups and body mass index (BMI) were recorded. Another 282 healthy individuals(male 127, female 155) were chosen as normal controls (Group A),whose BMDs were measured.Results:â‘ The level of the bone density in diabetic patients was lower than that in Group A (P <0.05), however, no significant difference was found between Group B and Group C.â‘¡The bone density level of men was higher than that of women in Group C (P <0.05).â‘¢There were no differences in FBG, Ca, P and ALP between Group B and Grope C, but HbA1c was significantly decreased in Group C(P <0.05) . â‘£The change in BMD of the Radius, Femur, Lumbar vertebrae 2-4 was respectively positive correlated with the change in BMI(r=0.201, P<0.05;r=0.349 ,P<0.05;r=0.207,P<0.05) and weight (r=0.230, P<0.05;r=0.352 ,P<0.05;r=0.223,P<0.05), while it had a negative correlation with age(r=-0.197, P<0.05; r=-0.073, P<0.05,r=-0.129,P<0.05) and duration(r=-0.218, P<0.05;r=-0.018, P<0.05,r=-0.135,P<0.05). The change in BGP was respectively positive correlated with Ca and ALP(r=0.218,P<0.05;r=0.127,P<0.05),while it had a negative correlation with the change in age or FBG( r=-0.266,P<0.05;r=-0.453,P<0.05).The change in CT was respectively negative correlated with the change in age or ALP ( r=-0.227, P<0.05;r=-0.451,P<0.05) .Conclusions Bone mineral density was decreased in type 2 diabetic patients and female, old, long duration and low birth weight were risk factors for osteoporosis with diabetic patients. No significant negative impacts for bone metabolism were found in type 2 diabetes mellitus with insulin application.