Investigation Of The Correlative Factors For Osteoporosis Among Elderly Male Patients With Type 2 Diabetes

Objective To explore the related factors for osteoporosis among elderly male patients with type 2 diabetes in order to provide some guidance for the prevention and treatment of osteoporosis of elderly male patients with type 2 diabetes.Methods 418 elderly male patients with type 2 diabetes were divided into 3 groups according to the diagnosis standards of osteoporosis: osteoporosis group(n=134),ostepenia group(n=158)and normal group(n=126).Height,weight and body mass index(BMI)were measured.Serum phosphorus(P),serum calcium(Ca),glycosylated hemoglobin A1c(Hb A1c),parathyroid hormone(PTH),fasting blood glucose(FBG),serum 25-hydroxyvitamin D(25-OH-VD)and urinary albumin/creatinine ratio(UACR)were detected.Diabetic course,diabetes specific therapy were recorded.Patients were diagnosed with diabetic nephropathy(DN)according to UACR?30mg/g Cr,and they were divided into microalbuminuria group(300mg/g Cr > UACR?30mg/g Cr)and macroalbuminuria group(UACR?300mg/g Cr).Diabetic retinopathy(DR)was examined by fundus examination or fundus camera.Diabetic peripheral neuropathy(DPN)was confirmed by physical examination and nerve conduction velocity(NCV)examination.Results(1)Among 418 cases of elderly male patients with type 2 diabetes,the prevalence of osteoporosis is 32%,the prevalence of abnormal bone mass is 70%.(2)For the comparison of normal group with ostepenia and osteoporosis groups,diabetic course was longer and level of Hb A1 c was higher(P<0.05 or P<0.01),and osteoporosis group showed longer diabetic course and higher level of Hb A1 c than ostepenia group(P<0.05 or P<0.01).Compared with normal group,BMI was decreased in ostepenia and osteoporosis groups(P<0.01).While osteoporosis group showed higher level of PTH compared to normal and ostepenia groups(P<0.05).The level of 25-OH-VD was below the normal level in all patients,but there was no difference in 25-OH-VD between the 3 groups(P>0.05).For the comparison of normal group with ostepenia and osteoporosis groups,the level of bone mineral density(BMD)of femoral neck,Ward's triangle region,greater trochanter and lumbar spine L2-4 were decreased(P<0.01),and osteoporosis group showed lower BMD value of femoral neck,Ward's triangle region,greater trochanter and lumbar spine L2-L4 compared with ostepenia group(P<0.05).(3)Correlation analysis showed that BMD value of femoral neck,Ward's triangle region,greater trochanter and lumbar spine L2-4 were positively correlated with BMI(r=0.574,r=0.609,r=0.814,r=0.795;all P<0.01),but negatively correlated with Hb A1c(r=-0.603,r=-0.768,r=-0.733,r=-0.642;all P<0.01).(4)The incidences of DN and DR were higher in osteoporosis group than in normal and ostepenia groups(P<0.01).The incidence of DPN was higher in osteoporosis group than in normal group(P<0.05).The BMD values of femoral neck,Ward's triangle region,greater trochanter and lumbar spine L2-4 in macroalbuminuria and microalbuminuria groups were lower than in non-diabetic nephropathy group(P<0.05 or P<0.01),and compared with microalbuminuria group,the BMD values of femoral neck,Ward's triangle region,greater trochanter and lumbar spine L2-4 were lower in macroalbuminuria group(P<0.05).(5)There was no difference in FBG?Ca?P?oral antidiabetics or insulin therapy between the 3 groups(P>0.05).(6)Logistic analysis showed that BMI,Hb A1 c and diabetic nephropathy were correlated with diabetetic osteoporosis.Conclusions 1.Among elderly male patients with type 2 diabetes,the prevalence of osteoporosis is 32.0%,the prevalence of abnormal bone mass is 70.0%.2.Low BMI,long diabetic course,poor blood glucose control and diabetic nephropathy are risk factors for osteoporosis among elderly male patients with type 2 diabetes.3.The treatment of oral hypoglycemic agents and insulin therapy are no difference of incidence of osteoporosis among elderly male patients with type 2 diabetes.