Study On The Correlation Between Serum Sodium Concentration And BMD In Type2Diabetes Patients

Objective: To explore the correlation between serum sodium concentration andBMD, and the influence factors of BMD in Type2diabetes patients.Methods:1. A total of371consecutive male and female T2DM patients who underwent bonemineral density measurement (DXA) at L1, L2, L3, L4, L1-4, right femoral neck,Ward’s triangel and Great trochanter. Quantifying the bone mineral density situation atnormal、decreasing and osteoporosis.2. We divided the T2DM patients in two groups, one was Hyponatremia ([SNa]＜135mmol/L), the other was Normal serum sodium group([SNa]:135-155mmol/L). Afteradjusting for age, sex, weight, body mass index and course of disease, two group warematched in1:4, compared BMD between two groups.3. Study on the correlation between BMD and FPG,2hPG, HbA1c, ALP, BUN, Cr,TC, TG, HDL, LDL, E2, T, LH, FSH, FC-P,2hC-P, S[Ca], S[P], S[Mg], S[Na], S[K],S[Cl] of T2DM patients.4. Study on the correlation between serum sodium concentration and the L1, L2,L3, L4, L1-4, right femoral neck, Ward’s triangel and Great trochanter BMD in patientswith T2DM.5. Evaluation the correlation between serum sodium to osteoporosis in T2DM.Results:1. According T value showed: BMD at each position from normal to osteoporosiswas L1:77.38%,19.35%,3.27%; L2:75.88%,19.24%,4.88%; L3:77.72%,17.93%,4.35%; L4:81.74%,14.99%,3.27%; L1-4:80.11%,15.47%,4.42%; Ward’s triangel:44.41%,46.05%,9.54%; Right femoral neck:71.12%,26.98%,1.90%; Greattrochanter:84.74%,14.71%,0.55%; 2.(1) The number of Hyponatremia and normal serum sodium group was separated32(8.6%) and339(91.4%), the mean serum sodium concentration [SNa] was(131.27±3.18) mmol/L and (139.96±1.96) mmol/L, the mean of age was (60.25±10.53)and (57.79±6.57);(2) After adjusting age, sex, weight, BMI and course of disease, two group waspaired1:4, the BMD in Hyponatremia was lower than normal serum sodium group, theBMD was statistically significant in two group, L1(0.94±0.23vs1.07±0.16, t=3.071, P＜0.01), L2(0.96±0.19vs1.15±0.18, t=5.030, P＜0.01), L3(1.00±0.34vs1.17±0.16, t=5.360, P＜0.01), L4(1.07±0.26vs1.22±0.17, t=4.010, P＜0.01),L1-4(1.00±0.25vs1.17±0.16, t=4.679, P＜0.01).3.(1) There was no significant difference between serum potassium and BMD;Serum sodium was positively correlated with L1(r=0.149, P=0.004), L2(r=0.136, P＜0.01), L3(r=0.129, P＜0.05), L1-4(r=0.140, P＜0.01), Right femoral neck(r=0.147, P＜0.01), Ward’s triangel (r=0.136, P＜0.01), Hip bone(r=0.181, P＜0.01); Serum chloridewas negatively correlated with Right femoral neck(r=0.129, P＜0.05), and positivelycorrelated with Hip bone(r=0.164, P＜0.01);(2) The relationship of FPG,2hPG, HbA1c, ALP, BUN, Cr, TC, TG, HDL, LDL,E2, T, LH, FSH, F c-p,2hc-p, S[Ca], S[P], S[Mg], S[Na], S[K], S[Cl] with BMD wasanalyzed using multiple linear regression, male patients: The weight (β=0.288,P=0.001), BUN (β=0.164, P＜0.05), Cr(β=0.232, P＜0.01), Na(β=0.225, P＜0.01)were positively correlated with L1-4BMD, ALP (β=-0.247, P＜0.01) was negativelycorrelated with L1-4BMD. The height (β=0.219, P＜0.01), BMI(β=0.196, P＜0.05),BUN(β=0.197, P=0.P＜0.05) were positively correlated with Right femoral neckBMD, The age (β=-0.310, P＜0.01), HbA1c(β=-0.172, P＜0.05), ALP(β=-0.244, P＜0.01) were negatively correlated with Right femoral neck BMD. The height (β=0.246, P＜0.01), BMI (β=0.228, P＜0.01), BUN(β=0.202, P＜0.05),2hC-P (β=0.212, P＜0.01) were positively correlated with Greater trochanter BMD, Theage(β=-0.285, P＜0.01), ALP(β=-0.261, P＜0.01), K(β=-0.188, P＜0.01)were negatively correlated with Greater trochanter BMD. Female patients: The Cr(β=0.166, P＜0.05), Na (β=0.157, P＜0.05) were positive correlated with L1-4BMD,ALP (β=-0.338, P＜0.01) was negatively correlated with L1-4BMD. The age(β=-0.504, P＜0.01), ALP (β=-0.273, P＜0.01), Mg (β=-0.132, P＜0.05),24MA(β=-0.241, P＜0.01) were negatively correlated with Right femoral neck BMD. TheBMI (β=0.325, P＜0.01), FSH (β=0.165, P＜0.05) were positively correlated with Hip bone BMD, age (β=-0.452, P＜0.01), ALP (β=-0.181, P＜0.05) were negativecorrelated with Hip bone BMD.4.International society for clinical densitometry in2004pointed out that Lumbar isthe most suitable site for monitoring BMD, So to study the relationship between serumsodium value and lumbar osteoporosis, taking L1-4BMD as a golden standard, selectedosteoporosis group(7,9) and non-osteoporosis (25,119) in Hyponatremia group and normalblood sodium group, using chi-square test:OR=3.702,95%CI1.260-10.877, P＜0.05.Conclusion:(1) Our study verified that Ward’s trangle was the most sensitive position of bonemass decreasing and osteoporosis.(2)The age, weight, height, BMI, ALP, Cr, HbA1c, BUN, S[K], S[Na], S[Mg],2hc-p,24MA and FSH were the risk factors of bone mineral density change.(3)Serum sodium was correlated with L1, L2, L3, L1-4, Right femoral neck,Ward’s triangel and Hip bone.(4)Hyponatremia was a risk factor of osteoporosis.