| Objective: To study the changes of bone mineral density(BMD) in hospitalized patients with type 2 diabetes mellitus(T2DM), analyze the factors related to osteoporosis complicated with T2 DM, and provide evidence for early diagnosis and prevention of diabetic osteoporosis(DOP).Methods: According to their average BMD values, the 733 cases of hospitalized patients with type 2 diabetes were divided into bone mass normal group(group A),reduced bone mass group(group B) and osteoporosis group(group C), then we compared the differences among these three groups in terms of gender, age, body mass index(BMI), duration, fasting plasma glucose(FPG), one hour postprandial blood glucose(1h PG), two hour postprandial blood glucose(2h PG), fasting insulin(FINS), one hour postprandial insulin(1h INS), two hour postprandial insulin(2h INS),insulin resistance(Homa IR) and insulin sensitivity index(ISI), glycosylated hemoglobin(Hb A1c), quantitative of urinary albumin, blood lipid, uric acid,parathyroid hormone(PTH), serum calcium(Ca), phosphorus(P) and bone alkaline phosphatase(BALP). Based on these comparisons we conducted a correlation analysis.Results: 1, The detection rate of Low bone mineral density among hospitalized patients with T2 DM was 49.7%, while the detection rate of osteoporosis(OP) was12.4%. The detection rate of female patients with OP was higher than that of male patients, and this difference was statistically significant(P<0.05). 2, According to the clinical data, the age and duration of group C were significantly higher than group A,and group B(P<0.05), and the age of group B was significantly older than that of group A(P<0.05), but there was no significant difference between group A and B in the duration(P>0.05); and the BMI of group C was significantly higher than those of group A and B(P<0.05), meanwhile the BMI of group B was significantly greater than that of group A(P<0.05). 3, In the comparison of blood glucose and insulin levels, the FPG and 2h PG of group C were significantly higher than those of group A and group B(P<0.05), and the 2h PG of group B was significantly greater than that of group A(P<0.05), but there was no significant difference between group A and group B in the FPG level(P>0.05); the Homa-IR of group A is significantly less than those of group B and group C(P<0.05), the ISI of group A was significantly greater than those of group B and group C(P<0.05), but there was no significant difference between group B and group C in Homa-IR, ISI(P>0.05); for 1h PG, FINS, 1h INS,2h INS, Hb A1 c, we did not observe significant difference among the three groups(P>0.05). 4, in the comparison of metabolic indices, HDL-C levels in group C was significantly higher than these of group A and group B(P<0.05); the uric acid levels of group A and group B were significantly higher than that of group C(P<0.05),and uric acid in group A was significantly higher than that of group B(P<0.05); and it showed no significant difference among these three groups in terms of microalbuminuria, TC, TG, and LDL-C(P>0.05). 5, In the comparison of bone metabolic markers and BMD values, the lumbar spine(L1-L4) and femoral neck BMD values of group A and group B were significantly higher than those of group C(P<0.05), while, all the BMD values of group A was greater than those of group B(P<0.05); the BALP and PTH of group A and B were significantly lower than those of group C(P<0.05), and the BALP of group A was significantly lower than that of group B(P<0.05), but there was no significant difference between group A and B in PTH(P>0.05); but the blood calcium and phosphorus among the three groups had no significant difference(P>0.05). 6, T2 DM patients with BMI, FINS, ISI and uric acid positively correlate to various parts of the BMD values(P<0.05), the age, FPG, 2h PG,Homa-IR, and HDL-C negatively correlate to various parts of the BMD values(P<0.05). 7, After multiple further regression analyses, we have seen that age(?=-0.041, P=0.000), BMI(?=0.063, P=0.005), FPG(?=-0.236, P=0.000),HDL-C(?=-0.649, P=0.005), uric acid(?= 0.002, P=0.047) remaine independent to BMD.Conclusions: 1, More than 60% of the type 2 diabetes patients whose ages are over 50 will have bone loss and OP, and compared with men, the postmenopausal women are more likely to suffer from the OP. 2, older age, low weight, long duration of diabetes, poor fasting blood sugar control, poor function of insulin, insulin resistance, low high density lipoprotein cholesterol, uric acid were risk factors of type 2 diabetes mellitus and osteoporosis. |
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