Changes Of Bone Metabolic Markers During Orthopaedic Perioperative Period In Elder Male Patients With Type2Diabetes

Objective To observe the changes of bone metabolic markers of the elder malepatients with type2diabetes during orthopaedic perioperative period．Methods To measure Bone Gla protein(BGP)、N-terminal telopetide of type Icollagen(NTX)、Tartrate-resistant acid phosphatase-5b(TRAP-5b) in serum of48elder male patients with type2diabetes before and two weeks after operation,allpatients aged60to85years, average of71.2±6.6years. According to the history ofdiabetes and the World Health Organization (WHO) in1999type2diabetes diagnosisand classification criteria,all subjects were divided into24cases of type2diabetesand24cases of non-diabetic group.Results1.The NTX level and TRAP-5b level of postoperative weresignificantly higher than the preoperative（P＜0.01）,but the BGP level was lower(P＜0.05). The postoperative NTX level and TRAP-5b level changed in type2diabeticpatients and osteoporotic patients were more significantly than that in patientswithout diabetic and osteoporosis（P<0.05）,The changes of three bone metabolicmarkers were smaller in insulin group after surgery(P<0.05).2.All patients weregrouped by hypoglycemic drugs,the difference of BGP,NTX,TRAP-5b in insulingroup was less then oral drugs group（P<0.05）.3.The reduce of BGP and theincreased of NTX、TRAP-5b were more obvious in osteoporosis patients anddiabetics whose course of disease more than10years.4. All type2diabetic patientswere divided into osteoporosis group and non osteoporosis group,the decrease ofBGP and rise of NTX,TRAP-5b in osteoporosis group were obvious than nonosteoporosis group.Conclusions This study shows that the postoperative serum NTX andTRAP-5b level were higher than preoperative serum NTX and TRAP-5b level,whichshows bone absorption was increased after operation.Compare with the BGP level inserum postoperative stage was lower than preoperative stage, the new bone formationwas decreased.The postoperative NTX and TRAP-5b level changed in type2diabetespatients and osteoporotic patients were more significant than that in patients without diabetes and osteoporosis, and related with the use of hypoglycemic drugs.