Analysis On Changes And Correlative Factors Of Bone Metabolism Markers And Bone Mineral Density In Newly Diagnosed Type 2 Diabetes Mellitus Patients

Objective:To study the changes of bone mineral density(BMD)and bone metabolism markers in newly diagnosed type 2 diabetes mellitus(T2DM)patients,and to analyze the risk factors of diabetic osteoporosis(DO),so as to provide evidence for early diagnosis and treatment of DO.Methods:90 newly diagnosed T2 DM patients were collected from April 2017 to October2017 in the Endocrinology Department of Xi’an Central Hospital.According to the BMD,the subjects were divided into group A with osteoporosis(n=34),group B with osteopenia(n=32),and group C with normal bone mass(n=24).To analyze the difference and correlation of age,sex,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),glycated albumin(GA),BMD,liver function,renal function,blood lipids,Ca(Calcium),P(Phosphorus),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),vitamin D(VD),Parathyroid hormone(PTH),bone alkaline phosphatase(BALP),carboxy-terminal telopeptide of type I collagen(CTX),tartaric acid phosphatase-5b(TRACP-5b),bone gla protein(BGP)and other indicators between the three groups.Results:1.The prevalence of OP in newly diagnosed T2 DM patients was 37.8%,the incidence of OP in female patients was higher than that in male patients,and the difference was statistically significant(P<0.05).2.the ages of group A and group B were significantly greater than that of group C,the differences was statistically significant(P<0.05),and there was no statistical difference between groups A and B(P>0.05).The BMI of Group A was less than that of group B and group C(P<0.05),but there was no significant difference between group Band C(P >0.05).3.the HbA1 c of group A was significantly higher than that of group C,and the HbA1 c of group A was significantly higher than that of group B,the difference was statistically significant(P<0.05).There was no statistical difference in FPG and GA of the three groups(P>0.05).4.BMD of group A and group B was significantly lower than that of group C in each part,and BMD of group A was significantly lower than group B in each part,the differences was statistically significant(P<0.05).5.BGP of group A and group B were significantly lower than that of group C,CTX,BALP,TRACP-5b of group A and group B were significantly higher than that of group C,and TRACP-5b of group A were significantly higher than that of group B,the differences was statistically significant(P < 0.05).There was no statistical difference in CTX,BALP,BGP between group A and group B(P > 0.05).6.The ALP in group A was higher than that in group C(P<0.05),but there was no statistical difference in group B and group C,group A and group B(P>0.05).The TG,TC,LDL-C and VD in group A were significantly lower than that in group C(P<0.05),but there was no significant difference with group B(P>0.05).There were statistically significant differences in TC and VD between group B and group C(P<0.05),and there was no statistically significant difference in TG and LDL-C between group B and group C(P>0.05).7.The correlation analysis of bone metabolism markers and BMD found that both CTX and tracp-5b were negatively correlated with BMD in each part(P<0.05).BGP was positively correlated with BMD in each part(P<0.05).BALP was negatively correlated with the bone mass of the femoral neck(P<0.05),with no correlation with lumbar L1,lumbar L2,lumbar L3 and lumbar L4(P>0.05).8.BMD of lumbar L1 was positively correlated with BMI,TC,TG and VD(P<0.05),and was negatively correlated with ALP(P<0.05).BMD of lumbar L2 was positively correlated with BMI,TG and VD(P<0.05),and was negatively correlated with ALP(P<0.05).BMD of lumbar L3 was positively correlated with BMI,TG and VD(P<0.05).BMD of lumbar L4 was positively correlated with BMI,TG and VD(P<0.05).BMD of the femoral neck was positively correlated with BMI,TC,TG,LDL-C and VD(P<0.05),and was negatively correlated with age and HbA1c(P<0.05).Conclusion:1.The incidence of OP in the newly diagnosed T2 DM patients is higher,and the incidence of OP in female patients is significantly higher than that of male patients.2.Poor long-term blood glucose control,advanced age,low body weight,abnormal lipid metabolism and VD deficiency are the risk factors of OP in the newly diagnosed T2 DM patients.3.Bone metabolism markers can be used as an early monitoring indicators of bone metabolism in the newly diagnosed T2 DM patients.