| Objective:To analyze the relationship between serum uric acid level and bone mineral density and bone turnover markers in patients with type 2 diabetes,and to explore the effect of uric acid on bone metabolism.Methods:Type 2 diabetes patients admitted to the Department of Endocrinology in our hospital from January 2017 to October 2018 were selected.Men were required to be older than 50 years old and women were postmenopausal women.According to the inclusion and exclusion criteria,a total of 323 subjects were selected to collect basic data.They were tested for uric acid?UA?,fasting blood glucose?FPG?,glycosylated hemoglobin?HbAlc?,homocysteine?Hcy?,calcium(Ca2+),Alkaline phosphatase?ALP?,?-caroxyl peptide,?-CTX,type I procollagen N-terminal proeptide?PINP?,parathyroid Metathyroid hormone?PTH?,25-hydroxyvitamin D?25?OH?VD?,osteocalcin?OC?,blood lipid series and other indicators,and the lumbar spine L1-4 bone density was measured.?1?Compare the basic characteristics of male and female subjects;?2?Divided patients into low uric acid group?U1 group?,normal uric acid group?U2 group?,high uric acid group?U3 group?according to uric acid level?normal range 210-440mmol/L?,compare the differences of bone mineral density and other indicators between the three groups;?3?According to the bone density T value level,the patients were divided into normal bone mass group?T1 group?,bone mass reduction group?T2 group?,osteoporosis group?T3 group?,compare the differences of uric acid and other indicators between the three groups;?4?Determine the correlation between uric acid and bone mineral density and bone turnover index by Pearson/Spearman correlation analysis and multiple linear stepwise regression analysis;?5?The ROC working curve was used to determine the threshold value of uric acid in predicting osteoporosis in males and females.Results:?1?Male HbAlc,UA,T value,OC,25?OH?VD,TG were higher than female,TC and ALP were lower than female,the difference was statistically significant?P<0.05?;?2?T value,duration of diabetes and TC of male hyperuric acid group were higher than those of low uric acid group;T value,BMI,FPG,Hcy,?-CTX,25?OH?VD,PTH and TC of female high uric acid group were high.In the low uric acid group,the difference was statistically significant?P<0.05?;?3?In the male osteoporosis group,age,duration of diabetes,Hcy,TC were higher than normal bone mass,BMI,UA,25?OH?VD was lower than normal bone mass;female osteoporosis group was in age,duration of diabetes,HbAlc,FPG,Hcy,?-CTX,OC,and TC were higher than the normal bone mass group,and BMI,UA,25?OH?VD,and PTH were lower than the normal bone mass group.The differences were statistically significant?P<0.05?;?4?Male UA was positively correlated with T value,25?OH?VD,OC,and female UA was positively correlated with T value,25?OH?VD,PTH and OC,P<0.05.And after correcting the interference of related confounding factors,uric acid is still positively correlated with lumbar spine bone mineral density;?5?Blood uric acid has predictive value for osteoporosis.The corresponding blood uric acid level is 345?mol/L for males and 325?mol/L for females.Conclusion:?1?There was a positive correlation between serum uric acid level and lumbar vertebrae bone density in patients with type 2 diabetes.Uric acid was positively correlated with 25?OH?VD?PTH and OC.?2?Age,duration of diabetes,Hcy and TC were risk factors for osteoporosis,and BMI,UA and 25?OH?VD were protective factors for osteoporosis.?3?Diabetes course,BMI,FPG,Hcy and TC were risk factors for hyperuricemia.?4?The normal high blood uric acid level is more conducive to the maintenance and stability of bone mass. |
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