The Study Of Related Factors Of Bone Mineral Density And Bone Turnover Markers In Young And Middle-aged Male Patients With Type 2 Diabetes

Objective:To investigate the changes of bone mineral density(BMD)and bone turnover markers(BTMs)in middle-aged men with type 2 diabetes(T2DM),and to determine the effects of glucose and lipid metabolism abnormality on BMD and BTMs.Methods:(1)We collected the clinical data of 30-50 years old male patients with type 2 diabetes who admitted to Tianjin Metabolic Diseases Hospital from January 2012 to January 2018.According to DXA results,they were divided into group A(Z value ? 1.0)and group B(Z value >-1.0),and then we compared the difference of general data and laboratory results between the two groups,explored the related factors of BMD in middle-aged male patients with type 2 diabetes.(2)We Chose 167 male patients aged 30-50 years old with type 2 diabetes in Tianjin Metabolic Diseases Hospital from December 2017 to February 2018 as T2 DM group,and 57 non-diabetic men from the physical examination center were selected as control group.The general and laboratory data of the two groups were collected.At the same time,we detected the serum levels of PINP,CTX,OC and PTH.We compared the differences of general data and BTMs between the two groups and explored the correlation between glucose and lipid metabolism markers and BTMs in T2 DM group,and explored the related factors of BTMs.Results:1.The levels of HbA1 c,TG,HDL,LDL,ACR and UMA in group A were statistically higher than those in group B.2.Correlation analysis showed that the serum levels of HbA1 c and HDL were both negatively correlated with BMD of lumbar spine and femur,the level of LDL was negatively correlated with BMD of L4 only.Multiple linear regression analysis showed the levels of HDL and HbA1 c were independently affect BMD of lumbar spine and femur.3.The levels of FBG,TG,TC and LDL and in T2 DM group were higher than those in control group,while the levels of PINP,OC and PTH were lower than those in control group.There were no significant difference in CTX-1 between the two groups.4.Pearson correlation analysis showed that HbA1 c was positively correlated with PINP,and negatively correlated with PTH.TG was negatively correlated with CTX-1 and OC.Multiple regression analysis showed that HbA1 c was positively correlated with PINP,while negatively correlated with PTH.TG was negatively correlated with OC.Conclusion: 1.The levels of HbA1 c and HDL were negatively correlated with BMD of lumbar spine and femur in young and middle-aged men with type 2 diabetes.Poor glucose control and lipid metabolism disorder were independent factors affecting BMD.2.The levels of TG,TC and LDL were higher in young and middle-aged men with type 2 diabetes than control group,suggesting that diabetic patients were easily complicated with lipid metabolism disorder,and their bone formation markers were decreased.3.There was a significant correlation between glucose and lipid metabolism and bone turnover in middle-aged men with type 2 diabetes mellitus.Glucose and lipid metabolism may affect bone metabolism through different pathways in patients with type 2 diabetes.