| Objective This study was to investigate the changes of blood glucose,insulin,blood lipids,thyroid function,blood uric acid,homocysteine,bone turnover markers,and other test results in elderly patients with type 2 diabetes mellitus(T2DM)at different bone mineral density.To explore the related risk factors and related relationship of bone metabolic abnormalities in elderly patients with T2 DM.Methods Collected a total of 524 elderly patients(age?60 years)with T2 DM from the First Hospital of Lanzhou University from June 2016 to December 2017.After exclusion of the criteria,362 elderly patients(age?60 years)with T2 DM were enrolled.According to the T value of bone mineral density,elderly T2 DM patients were divided into three groups,such as normal(94 cases),osteopenia(132 cases)and osteoporosis(136 cases).Using enzyme-linked immunosorbent assay(ELISA)and dual-energy X-ray(EXA-3000)detection methods,the gender,age,ethnicity,occupation,body mass index(BMI),duration of illness,smoking history,drinking history,hypertension history,diabetes history,common complications,fasting blood glucose(FPG),2 hours postprandial blood glucose(2hPBG),fasting insulin(FINS),2h postprandial insulin(2hINS),glycated hemoglobin(HbAlc),blood uric acid(UA),serum calcium,serum phosphorus,serum alkaline phosphatase(ALP),total cholesterol(TC),triglyceride Ester(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),homocysteine(HCY),urinary protein excretion rate(uAER),urine microalbumin(urine Alb),thyroid function,folic acid,vitamin B12,amino-terminal neutral segment osteocalcin(N-MIDBGP),bone-specific alkaline phosphatase(BAP),25-hydroxyvitamin D3(25-OH-D3).SPSS21.0 software was used for statistical analysis to analyze the risk factors and related factors of bone metabolism in elderly patients with T2 DM.Result(1)A total of 362 subjects were studied,including 94 patients with normal,132 patients with osteopenia,and 136 patients with OP.Among them,normal was 60-76 years old,with an average of(67.27±6.09)years old;osteopenia was 60-80 years old,with an average(68.61±6.20)years old;OP was 60-84 years old;with an average of(70.69± 6.90)years old;(2)In elderly T2 DM patients with osteopenia and OP,the incidence of females(54.55% and 75.00%)was significantly higher(P<0.05)than that of males(45.45% and 25.00%);The incidence of age increase was significantly increased and statistically significant(P<0.05).No correlation was found between the duration of diabetes and the duration of diabetes(P>0.05);(3)The prevalence of BMI in elderly T2 DM patients with OP was statistically lower than that in patients with normal and osteopenia(P<0.001);(4)Elderly T2 DM patients with normal,osteopenia,and OP had no significant difference in national and occupational status(P>0.05);there were no significant difference between insulin therapy history and hypertension history(P>0.05);there were statistical differences in drinking history,smoking history and smoking index(P<0.05);(5)The elderly T2 DM patients with OP had statistical significance in retinopathy,nephropathy,and peripheral neuropathy(P<0.05);(6)The UA levels in elderly T2 DM patients with osteopenia and OP were significantly lower than those in elderly T2 DM patients with normal,but the levels of ALP and HDL-C were significantly higher than those in elderly T2 DM with normal,and there was a statistical difference between the OP group and the normal(P<0.05).The HCY levels in elderly T2 DM patients with OP were significantly higher than those in normal.There were no significant difference in N-MIDBGP,BAP and 25-OH-D3 in bone turnover markers,but N-MIDBGP,BAP and 25-OH-D3 levels decreased compared with the normal;(7)Using correlation analysis,the results showed that the T value of BMD in elderly T2 DM patients with OP were negatively correlated with age,smoking index,ALP,HDL-C and T4,and positively correlated with BMI and UA.The differences were statistically significant(P< 0.05);(8)Using sequential multi-classified Logistic regression analysis,after adjusting for confounding factors,the results showed that age,smoking index,ALP and HCY were risk factors,and BMI,UA were protective factors.Conclusions The incidence of OP in elderly patients with T2 DM is relatively high,showing ageing changes,especially in women.The lower the BMI,the higher the risk of OP;the higher the incidence of diabetic complications in older T2 DM patients with OP,leading to bone loss.The odds were significantly higher;smoking,drinking and other unhealthy lifestyles were among the risk factors for elderly T2 DM with OP;and age,BMI,UA,ALP,HCY,TC,HDL-C,T4 were the factors affecting bone metabolism in elderly T2DM;bone turnover markers were N-MIDBGP,BAP,25-OH-D3 and bone metabolism had no significant difference.To explore the risk factors of T value has important clinical significance for early detection of fracture risk and timely prevention and comprehensive treatment of risk factors. |
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