| Objective To investigate the relationship between bone mineral density and serum uric acid levels in elderly patients with type 2 diabetes.Methods We selected elderly patients with type 2 diabetes admitted to Department of endocrinology in First Hospital Affilliated to Lanzhou University from June 2015 to October2016.Bone mineral density was measured by dual energy X-ray absorptiometry in all subjects,fasting blood sample was taken to determine FPG,serum uric acid,HbA1 c,serum calcium,serum phosphorus,25 OHD and other indexes,to compare the difference of bone mineral density,serum uric acid and other indexes between male and female.Bone mineral density status was divided into normal bone mass group(T≥-1),osteopenia group(-1<T<-2.5)and osteoporosis group(T≤-2.5)according to T level,to compare the difference of serum uric acid levels between groups in patients with type 2 diabetes.Serum uric acid levels was divided into group 1(147-295umol/L),group 2(296-367umol/L)and group 3(369-645umol/L)grades according to the tertiles of uric acid,to compare the difference of calcaneus bone mineral density between groups in patients with type 2 diabetes.Person correlation analysis and multiple linear regression analysis were used to confirm the relationship between bone mineral density and serum uric acid levels in elderly patients with type 2 diabetes of different genders.Results(1)There were 263 cases in the study,141(53.6%)subjects were male and 122(46.4%)sbjects were femal.There was no significant difference in mean age between male and female(71.5±5.1 years old vs 71.4±5.0 years old,P>0.05).There was no significant difference in BMI between male and female(P>0.05).The mean calcaneus BMD in male was significantly higher than that in female(0.574±0.145 g/cm2 vs 0.324±0.109 g/cm2,P<0.001).There was no significant difference in mean serum uric acid levels between male and female(P>0.05).The concentration of 25 OHD in male was significantly higher than that in female(P<0.01).(2)Thepercents of type 2 diabetes with normal bone mass group,osteopenia group and osteoporosis group are 36.9%,30.8%,32.3%,respectively.The osteoporosis prevalence of female is higher than male(48.4% vs 18.4%,P<0.001).BMI in osteoporosis group is significantly lower than that in normal group(P<0.001).After adjusted confounding factors,the serum uric acid levels in the normal bone mass group was higher than that in the osteoporosis group among patients with type 2 diabetes(345.38±76.96 umol/L vs 317.02±99.71 umol/L,P=0.042);There was a statistical difference of serum uric acid levels between normal bone mass group and osteoporosis group in male patients(344.73±78.63 umol/L vs 309.85±76.58 umol/L,P=0.049);However,there was no statistical differences in female patients between groups.After removing the confounding factors,the mean bone mineral density of group 3 was significantly higher than that of group 1 among patients with type 2 diabetes(0.491±0.196 g/cm2 vs 0.425±0.180 g/cm2,P=0.004);The mean bone mineral density of group 3 was higher than that of group 1 among male patients with type 2 diabetes(0.619±0.136 g/cm2 vs 0.543±0.167 g/cm2,P=0.039);However,there was no statistical differences in female patients between the groups.The average BMI in group 3 was higher than group 1(P=0.043).(3)There was a positive correlation between serum uric acid levels and calcaneus bone mineral density in male patients with type 2 diabetes mellitus,and the relative index was 0.227(P<0.01).However,there was no significant correlation in female patients with type 2 diabetes.(4)Multiple linear regression analysis results showed that the calcaneus bone mineral density was positively correlated with serum uric acid levels in male patients with type 2 diabetes after adjusting the confounding factors,adjusted R2 was 0.187(P<0.05).Conclusions Bone mineral density was increased with the increase of serum uric acid levels in elderly patients with type 2 diabetes;The bone mineral density was positively correlated with serum uric acid levels in elderly male patients with type 2 diabetes,normal high serum uric acid may have a protective effect on bone mineral density,the effect of serum uric acid on bone mineral density needs further study. |
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