The Investigation Of The Relationship Between The Levels Of NIR?RDW?MPV?UA?TBIL And Osteoporosis In Patients With Type 2 Diabetes

Objective:The high rate of morbidity,disability and mortality of Diabetes Mellitus and Osteoporosis nowadays make it increasingly becoming a serious public healthy problem.Following the increased risk of fractures for the patients with diabetes,bone metabolism is affected by diabetes through various mechanisms;the detail of the ways is complex and is not fully clear.The present studies have shown that chronic inflammation and oxidative stress are the important pathophysiological process in which neutrophil-lymphocyte ratio(NLR),red cell distribution width(RDW),mean platelet volume(MPV),uric acid(UA),total bilirubin(TBIL)play its respective role and finally result in Diabetes Mellitus and osteoporosis.This study compares the difference of NLR?RDW?MPV?UA?TBIL of type 2 diabetes patients with varied degrees of bone conditions and analyzes its correlation with osteoporosis to supply a reliable theoretical basis for the prevention and treatment of diabetic osteoporosis.Methods:Collecting data includes 1560 patients with type 2 diabetes with osteoporosis from August 2014 to August 2015 in Luzhou medical school affiliated hospital endocrinology,finally 380 been brought into,and these patients are accepted dual-energy X-ray absorptiometry(DEXA)to test two parts of the bone mineral density,including the lumbar spine and left hip bone mineral density.The diagnosis of type 2 diabetes is in line with the standard of diagnosis classification of World Health Organization(WHO),according to the diagnostic criteria for osteoporosis of WHO,and these patients above are divided into 3 groups:normal bone mass group(n=91),osteopenia group(n=140)and osteoporosis group(n=149).The parameters such as the gender,age,height,weight,systolic pressure,diastolic pressure,diabetes duration,the body mass index(BMI)and other related information are recorded,FBG,HbAlc,TG,TC,HDL-C,LDL-C,NLR,RDW,MPV,UA,TBIL are measured.The measurement data of normal distribution expressed by(x±SD)is analyzed through SPSS 19.0.Count data using X~2 test,two variables using liner correlation analysis,the multi-factor analysis using the Ordinal regression.P<0.05 is considered to be statistical significance.Results:The result of comparing the gender,age,height,weight,systolic pressure,diastolic pressure,diabetes duration,BMI,FBG,HbAlc,TG,TC,HDL-C,LDL-C,NLR,RDW,MPV,UA,TBIL among three groups shows the statistical difference among the groups of NLR,RDW,MPV,UA,TBIL(F= 10.290,4.131,6.446,72.647,98.220,P<0.05).Among the three groups,age and gender also exist statistical significance(F=7.329,98.318,X~2=12.062,P<0.05),but systolic pressure,diastolic pressure,the duration of diabetes,FBG,HbAlc,TG,TC,HDL-C,LDL-C have no statistical difference in three groups(P>0.05).2.Conducting the liner correlation between age,the duration of diabetes,BMI,FBG,HbAlc,NLR,RDW,MPV,UA,TBIL and the BMD of the average lumbar spine(L1-L4),femoral neck,wards,intertrochanteric,the result expresses:the negative correlation exists between the age,NLR,RDW,MPV,UA and the BMD of the average lumbar spine(L1-L4),and the femoral neck,wards,intertrochanteric,with the L1-L4 average BMD the correlation index respectively expresses with the femoral neck BMD the correlation index respectively expresses-0.244,-0.136,-0.523,-0.556,-0.306,P<0.05;with the wards BMD the correlation index respectively expresses-0.228,-0.131,-0.196,-0.084,-0.031,P<0.05,with the intertrochanteric BMD the correlation index respectively expresses-0.161,-0.118,-0.121,-0.067,-0.308,P<0.05,the result of the BMI,TBIL and the BMD of the average lumbar spine(L1-L4),femoral neck,wards,intertrochanteric express positively correlation,the correlation index respectively expresses 0.357,0.665;0.383,0.568;0.377,0.376;0.391,0.394,P<0.05.There are no correlation between the duration of diabetes,FBG,HbAlc and the BMD of the average lumbar spine(L1-L4),femoral neck,wards,intertrochanteric,with the correlation index respectively expresses 0.211,0.071,0.033;-0.152,-0.105,0.083;-0.057,-0.109,0.062;0.168,0.108,0.078,P>0.05.3.According to the bone condition of patients with type 2 diabetes,divides them into diabetics normal bone mass group,osteopenia group and osteoporosis group,regarding as a dependent variable,based on the single factor analysis standards(P<0.1),and gradually screens age,gender,BMI,TC,LDL-C,NLR,RDW,MPV,UA,TBIL,and then the 10 index regarded as independent variable process into Ordinal regression analysis,eventually age,gender,BMI,NLR,UA,TBIL associated with osteoporosis,among them above,the age,NLR,UA are considered as risk factors of osteoporosis(OR=2.208,1.013,P<0.05),compared with men,female has a higher risk of osteoporosis,which is same to be a risk factor;BMI,TBIL are considered as protective factors of osteoporosis(OR=0.470,0.420,P<0.05).Conclusion:1.The bone mineral density in patients with type 2 diabetes is influenced by age,gender,BMI.negative correlation exists between the age,NLR,RDW,MPV,UA and the BMD of the lumbar spine(lumbarl-4),femoral neck,wards,intertrochanteric.The BMI,TBIL and the BMD of the average lumbar spine(L1-L4),femoral neck,wards,intertrochanteric expresses positive correlation.2.Age,female,NLR,UA are regarded as risk factors of osteoporosis,BMI,TBIL are regarded as protective factors of osteoporosis.