Correlative Analysis Of Low Bone Mass And Thyroid Hormone Levels In Middle-aged And Elderly Patients With Type 2 Diabetes

Objective:Type 2 diabetes(T2DM)and osteoporosis(OP)are common diseases among middle-aged and elderly people.Due to their age characteristics,they have a wide range of patients,associated with more risk factors,and the prevalence rate is increasing.This study reviewed the correlation between risk factors and bone mineral density(BMD).The study reviewed the relationship between the bone mineral density(BMD)thyroid function of the T2 DM patients hospitalized in the Department of Endocrinology,the First Affiliated Hospital of Nanchang University.To clarify the risk factors of BMD reduction in T2 DM patients,so as to further guide OP risk assessment,prevention and treatment of patients with diabetes mellitus(DM).Methods:1.Type 2 diabetes patients admitted to the Department of Endocrinology,First Affiliated Hospital of Nanchang University from July 2015 to July 2017.Subjects aged ? 50 years and women were postmenopausal.According to the inclusion and exclusion criteria,972 subjects were included.2.Influencing factors: age,gender,duration of diabetes,HbA1 C,left hip bone density(T value),lumbar spine bone density(T value),body mass index(calculated based on height and weight),serum free Triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH).3.SPSS 22 statistical software is applied to statistical analysis of data.The results of measurement data are expressed as normal distribution with mean number + standard deviation(X + S),and the median(four division spacing)is not conformed to the normal distribution.T test and chi square test were used among the normal distribution data groups.Non parametric Mann-Whitney U test and Kruskal-Wallis test were used for non normal distribution data groups.The correlation analysis was analyzed by Pearson bivariate,Spearman bivariate correlation and partial correlation analysis.The risk factor analysis was analyzed by logistic regression analysis,P<0.05 was considered to be statistically significant.Result:1.There was significant difference in age,DM duration,FT3,TSH,HbA1 C and BMI between the BMD reduction of hip joint and the normal group(P<0.05).There was significant difference in age,FT3,TSH,BMI and gender between lumbar BMD reduction and normal group(P<0.05).2.The difference of BMI,TSH level and FT3 level between the hip joints BMD and lumbar BMD was statistically significant(P<0.05).3.Among the related risk factors of BMD changes in the male hip joint,age and the course of DM were negatively correlated with the BMD of the hip joint(P<0.05),and TSH and BMI were positively correlated with the male hip joint BMD(P<0.05).After correcting age and BMI,the correlation between DM duration,TSH and BMD of hip joint still exists.4.Among the risk factors associated with BMD changes in the male lumbar spine,HbA1 C was negatively correlated with the male lumbar BMD(P<0.05),and TSH and BMI were positively correlated with the male lumbar BMD(P<0.01).After correction of BMI,there was no significant correlation between TSH and HbA1 C and BMD of lumbar spine.5.Among the related risk factors of BMD changes in the female hip,age,the course of DM and the BMD of the hip joint were negatively correlated(P<0.05),and TSH and BMI were positively correlated with the female hip BMD(P<0.05).After correcting age and BMI,the correlation between TSH and hip BMD still exists.6.Among the related risk factors of lumbar BMD changes,age and BMI were positively correlated with lumbar BMD in females(P<0.01).After correction of BMI,age was negatively correlated with female lumbar BMD(r=-0.314,P<0.01).7.It was found that the risk rate of BMD reduction in the hip joint of 50?age<60 groups was 0.36 of the age>60 groups,and the group FT3<2.38 had a higher risk rate than the FT3>2.87 group(OR=1.21).The risk of hip BMD reduction in patients with BMI<24 was 2.56 times higher than that in patients with BMI over 24.8.The risk rate of lumbar BMD reduction in 50?age<60 group was 0.46 times that of age>60 group,and 1.76 times as much as those of TSH>2.87 in patients with 1.56 < TSH < 2.87.The risk rate of BMD reduction in BMI<24 was 3.78 times that of BMI more than 24,The incidence of lumbar BMD reduction in women is 5.66 times that of men.Conclusion:1.There was a positive correlation between TSH,BMI and male BMD in the hip and lumbar spine.HbA1 C was negatively correlated with lumbar spine BMD in men.TSH and BMI were positively correlated with female BMD.BMI was positively correlated with female lumbar spine BMD.2.Lower levels of FT3 are more likely to cause hip BMD reduction.Higher levels of TSH are protective factors for reduction of lumbar spine BMD.