Correlation Between Visceral Fat And Bone Mineral Density,Vitamin D And Other Metabolic Factors In Elderly Patients With Type 2 Diabetes

Objective:To study the correlation between abdominal fat distribution characteristics and bone mineral density,vitamin D and other metabolic factors in elderly patients with type 2 diabetes,and provide evidence for future prevention and treatment of diseases in clinical work.Methods:Collected A total of 125 T2DM male patients and postmenopausal female patients aged≥50 years old were enrolled in the endocrinology department of our hospital.Among them,82 males and 43 females used double bioelectrical impedance to measure visceral fat area(VTA).According to the diagnostic criteria of visceral fatty obesity,the VAT≥100cm~2 group was the H-VAT group,and the VAT<100cm~2 group was the L-VAT group.The relationship between VTA and bone mineral density,vitamin D and other factors was analyzed.All patients underwent dual-energy X-ray(DEXA)bone densitometry to detect lumbar spine+double femoral neck bone density;age,sex,smoking history,drinking history,past medical history,diabetes duration,BMI,waist circumference,Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),parathyroid hormone(PTH),thyroxine(TSH,FT3,FT4),aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphate Enzyme(ALP),cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),serum creatinine(CR),blood uric acid(SUA),blood calcium(Ca),blood phosphorus(P),25-(OH)D.indicators;Statistical processing:SPSS 18.0 statistical software for data analysis.The measurement data were expressed as mean±standard deviation.The t test was used for comparison between the two groups.Theχ2 test was used for comparison between the data groups.The correlation analysis between visceral fat and each index was analyzed by Pearson correlation analysis.The influencing factors were analyzed by multiple linear regression analysis.<0.05 is statistically significant.Results:(1)L-VAT group smoking,hypertension,body mass index,waist circumference was lower than H-VAT group,the difference was statistically significant(P<0.01).L-VAT group uric acid,TG,LDL-C were lower than H-In the VAT group,the difference was statistically significant(P<0.01).The HDL-C of the L-VAT group was higher than that of the H-VAT group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that BMI and waist circumference were positively correlated with VAT.(R=0.542,0.695,P<0.001).Uric acid,LDL-C and VAT were positively correlated(R=0.353,0.316,P<0.01).HDL-C was negatively correlated with VAT(R=-0.272,P<0.001).(2)L-VAT group bilateral femoral neck bone density,lumbar spine L1-4 bone density were higher than H-VAT group,and the bilateral femoral neck bone density was statistically significant between the two groups(P<0.05).L-VAT group 25(OH)D was higher than H-VAT group,the difference was statistically significant(P<0.05).Lumbar spine L1-4 bone density,bilateral femoral neck bone density was negatively correlated with VAT(R=-0.277,-0.210,-0.289,P<0.05).25(OH)D was also negatively correlated with VAT(R=-0.222,P<0.05).(3)Multiple linear regression analysis showed that VAT was an independent risk factor for lumbar L1-4 bone mineral density and25(OH)D levels(β=-0.002,P=0.002;β=-0 034,P=0.033).VAT,age is Risk factors for decreased bone mineral density in the left femur(β=-0.001,P=0.005;β=-0.005,P=0.025);VAT,duration of diabetes is a risk factor for decreased bone mineral density in the right femur(β=-0.002,P<0.001;β=-0.208,P=0.030).Conclusion:(1)Visceral visceral fat accumulation is common in middle-aged and elderly patients with type 2 diabetes.Lumbar vertebrae L1-4,bilateral femoral neck bone density,and 25(OH)D are negatively correlated with VAT.VAT is lumbar vertebrae L1-4 bone density and bilateral femoral neck bone.The independent risk factors for density and 25(OH)D reduction are closely related to the decrease in bone density and vitamin D.(2)BMI,waist circumference and VAT were positively correlated.Uric acid,LDL-C and VAT were positively correlated.HDL-C was negatively correlated with VAT.The number of hypertension was significantly different between the two groups.Visceral fat was related to metabolic factors.