| Objective:Investigate T2 DM patients with bone metabolism and bone mineral density, bone mineral density, BMD),and type 2 diabetes mellitus(type 2 diabetes and type 2 diabetes mellitus(T2DM) in patients with osteoporosis(insulinre- sistance, IR) level and bone metabolism related relationship.Methods:T2DM patients who were collected from the Department of endocrinology of the First Affiliated Hospital of Shihezi University from February 2014 to December-2015. According to the results of dual energy X-ray BMD examination, the subjects were divided into T2 DM group, normal bone mass group, T2 DM group, group, T2 DM and OP(osteoprosis, OP) group. Determination of the general information, including gender, age, height, weight, diabetes, such as the general clinical baseline data, calculated according to the formula of body mass index(mass index body, BMI). 2. The collection of objects of fasting venous blood samples after anticoagulation with heparin, and biochemical indexes of fasting plasma glucose(FPG),calcium(CA), phosphorus(P) were measured by automatic biochemical analyzer, serum total cholesterol(TC), triglyceride(TG), alkaline phosphatase(ALP) etc., high pressure liquid chromatography method for the determination of glycosylated hemoglobin(Hb A1c), chemiluminescence determination of fasting insulin(fins), according to the formula to calculate insulin resistance index(HOMA-IR). 3. The ELISA method and the corresponding ELISA kit for detection of serum beta-CTx and PINP. 4 using SPSS17.0statistical software for data processing. Measurement data was used to mean + standard deviation said,between groups were compared by analysis of variance, baseline together with covariance for processing,the relationship between variables using correlation analysis and multi factors using multiple linear regression analysis to P < 0.05, the difference was statistically significant.Results:General information: Subjects of 250 cases. The normal bone mass group 125 cases(men and women than83/42), the average age was 54.08 + 11.97 years; bone mass reduction group 82 cases(men and women than 46/36). The average age is 60.99 + 48 years old; OP group 43 cases(men and women than 10/33), the average age was 68.97 + 720 years. The three groups in age, sex ratio had statistical difference(P < 0.01),baseline data missing, to make the data comparable between groups, statistical processing of the data using covariance. 1, general information: compared with normal bone mass group, osteopenia group in the course of the disease was higher than that of normal group, with significant difference(P < 0.01), OP group body weight, BMI, duration of diabetes was significantly higher than that in the normal group, with statistical difference(P < 0.05). 2, three groups of biochemical indexes between the comparison results show that:compared with normal bone mass group, osteopenia group and the OP group between ALP, triglyceride,cholesterol, calcium, phosphorus were not statistically significant. 3, glucose metabolism indexes comparison shows that compared with normal bone mass group, osteopenia group of fasting insulin, insulin resistance index and OP group in fasting insulin, insulin resistance index was lower than that of normal group and Hb A1 c in the OP group was higher than that of normal group, with statistical difference, P <0.05. Compared with the bone mass reduction group, OP group Glycosylated Hb A1c(hemoglobin) was significantly higher than the reduction group, there were statistically significant differences between the two groups, P < 0.05. 4, among the three groups of biochemical markers of bone metabolism in comparison shows that compared with normal bone mass group, osteopenia group and the OP group PINP and CTX were higher than normal group,(P < 0.01), with reduced bone mass compared, OP group PINP and CTX were higher than group were significantly reduced, and the difference is statistically significant(P < 0.05).5, correlation analysis showed that the BMD(neck) with body weight, BMI, fins and HOMA-IR was positively related(= 0.18 and 0.13 and 0.14 and 0.18, P < 0.05); with age, CTX and PINP was negative correlation(r=-0.13,-0.23,-0.87, P < 0.05), BMD and duration, FPG, Hb A1 c without significantly associated(P > 0.05). IR and age, CTX was negative correlation(r=-0.15,-0.19, P < 0.05); with body weight, BMI, Hb A1 c, fasting insulin(fins) was(r = 0.16, 0.13, 0.2, 0.92, P < 0.05), HOMA-IR and duration, FPG, PINP no significant correlation. 6, regression analysis shows: with CTX and PINP as the dependent variable and the IR index, gender, age, BMI, duration of diabetes, fasting plasma glucose,Hb A1 c, ALP, triglyceride, cholesterol, serum calcium, phosphorus as independent variables for multiple linear regression analysis. Results showed that the IR index and CTX regression relationships in the 0.05 level was negatively correlated; CTX and age were positively correlated, namely age has a positive effect on CTX(t=3.559, P = 0.001) IR negative to the effect of CTX(t=-2.454, P = 0.015), PINP and gender(t=2.621, P = 0.009) positive correlation, and female PINP value is higher than the male.Conclusion:(1) in the present study, T2 DM combined with osteoporosis accounted for 17% of the research data, of which OP group of women accounted for 76.7%.(2) HOMA-IR and BMD were positively correlated, that is, IR is the protective factor of bone, the lower the IR, the more serious the loss of BMD, the greater the risk of OP.(3) T2 DM caused by OP is a high conversion of bone metabolism, that is, bone resorption and bone formation are increased. There was a negative correlation between IR and bone metabolism. The negative effect of beta-CTx and IR was negative, that is, low IR would cause the-CTx of bone metabolism beta,which led to the occurrence of OP.(4) PINP was related to sex, and the female PINP was higher than that of the male. The beta-CTx had a positive effect on the age, and the negative effect of IR was-CTx. Timely understanding of the status of patients with IR status and bone metabolism indicators, contribute to the early prevention and treatment of OP. |
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