Correlations Of Blood Lipid,Hcy And Bone Metabolism In Patients With Type 2 Diabetes Mellitu

BackgroundType 2 Diabetes Mellitus(Type 2 Diabetes Mellitus T2DM)is a clinical syndrome caused by genetic factors and environmental factors,resulting in sugar,fat,water and electrolyte metabolism disorder.There are 114 million diabetes patients and 493 million pre-diabetes patients in China currently.The serious complications associated with diabetes often have serious adverse effects on the physical and mental health of patients.Osteoporosis is one of the complications of diabetes and one of the important causes of disability and death in the elderly.Fracture and quality of life decline caused by osteoporosis need to be paid close attention to.The occurrence of diabetic complications is related to a variety of factors,among which dyslipidemia and Homocysteine(Hcy)are closely related to diabetic vascular lesions and diabetic peripheral neuropathy.Exploring the correlation between Hcy,blood lipid and diabetic bone metabolism can contribute to the pathogenesis of diabetic osteoporosis and its detection and treatment.PurposeTo study the correlation between age,course of diabetes,body mass index metabolic indexes and bone metabolism in patients with type 2 diabetes mellitus.The metabolic indexes included urea nitrogen,serum creatinine,cystatin c and various blood lipid components(Triglyceride,total cholesterol,Low-density lipoprotein cholesterol,High-density lipoprotein cholesterol).Bone metabolic indexes include bone mineral density,vitamin D,N-terminal osteocalcin,parathyroid hormone,?-cross linked telopeptides of type I collagen and blood type I collagen carboxyl terminal extension peptide.Through the correlation study of the above indicators to predict the risk factors of diabetic osteoporosis,so as to provide scientific guidance for the prevention and treatment of these diseasesMethodsIn this study,102 patients were selected from September 2018 to May 2019.According to the disease,102 patients were divided into three groups:group DM+OP(n=40)with diabetes complicated with osteoporosis,group DM(n=33)with simple diabetes,group OP(n=29)with only osteoporosis,and group HP(n=25)as control.First of all,it is necessary to obtain the basic information of the participants,including age,course of disease and so on.The levels of BMD,metabolic indexes and bone metabolic markers were measured in each group.Analyze the differences of blood lipids and Hcy in each group,and further analyze whether there is a correlation between blood lipids,bone metabolic markers and BMD in each group,and explore the correlation between blood lipids,Hcy and diabetes and osteoporosis in non-diabetic patients.Results1.Differences in age,course of disease,BMI and metabolic indicators among groupsThe age,disease course,BMI and metabolic index of each group were compared in pairs.The age of group HPM+OP was different from that of group HPM and group OP,and the age of group OP and group HP was different between groups.The BMI in group HPM+OP was significantly lower than that in group DM.OP and HP(P<0 05).2.Differences in markers of bone metabolism in each group.The level of PTH in group DM,OP and HP was significantly higher than that in group DM+OP,while the PTH level of group DM and group OP and group DM and group HP were not significantly different.The level of serum PlNP in group OP was higher than that in group DM+OP,but there was no significant difference in P1NP level among other groups.The level of vitamin D in group DM+OP was higher than that in group OP,the level of vitamin D in group HP was higher than that in group OP,and there was significant difference between groups(P<0.05),but there was no significant difference among other groups.3.Correlation between blood lipid,Hcy,bone metabolism markers and BMD in DM patients and non-dm patientsIn DM patients,BMD was positively correlated with TG,Cyc-C,Cr and ?-CTX.but negatively correlated with vitamin D,and BMD was positively correlated with Cr and ?-CTX.After limiting the age and BMI factors,partial correlation analysis showed that in DM patients,BMD was positively correlated with Cr,but significantly negatively correlated with P1NP.The above correlations were statistically significant(P<0.05).4.The correlation between BMD and blood lipid,Hcy,bone metabolism and other metabolic indexes in each groupThe levels of BMD and blood lipids,Hcy,bone metabolism and other metabolic related indexes in each group were analyzed.The level of BMD in group DM+OP was negatively correlated with Cho,TG and LDL-c,and negatively correlated with vitamin D and P1NP.There was a positive correlation between BMD and ?-CTX in group DM,a negative correlation between BMD and Cho in group OP,and a negative correlation between BMD and HDL-c in group HP.5.Correlation analysis between serum Hcy level and serum lipid and other metabolic indexes in each groupIn group DM+OP,the level of Hcy was proportional to Cyc-C;in group DM,the level of Hcy was positively correlated with the levels of Cyc-C,Cr and BUN;and in group OP,Hcy was negatively correlated with BUN and LDL-c.In group HP,Hcy was positively correlated with Cr.The above correlations were statistically significant(P<0.05).6.Correlation analysis of bone metabolism markers with Hcy and blood lipid in each groupIn DM patients,PTH was negatively correlated with HDL-c.vitamin D content was negatively correlated with Cho,TG and LDL-c,N-MID was positively correlated with HDL-c,?-CTX was negatively correlated with TG and LDL-c.In non-DM patients,PINP was negatively correlated with Cho,LDL-c and HDL-c.In group DM+OP,vitamin D content was negatively correlated with LDL-c and Cho,N-MID was positively correlated with HDL-c level,PTH was negatively correlated with LDL-c,vitamin D content was negatively correlated with Cho in group HPM.P1NP and LDL-c were negatively correlated in group OP,and vitamin D content was negatively correlated with TG in group HP.The above correlations were statistically significant(P<0.05).7.Correlation between GHb1 Ac level and markers of bone metabolismThe correlation between GHb1Ac level and BMD and markers of bone metabolism in all diabetic patients with osteoporosis(group DM+OP)and diabetic non-osteoporosis patients(group HPM)was studied.As shown in table 16,in group DM+OP patients,among them,GHb1Ac had no significant correlation with PTH,BMD,vitamin D,N-MID,?-CTX and P1NP.In group DM,GHb1Ac was significantly positively correlated with P1NP,(P<0.05),but not with BMD,PTH,N-MID and ?-CTX.8.Correlation between blood lipid,Hey and osteoporosisUsing logistics binary regression analysis,the results are obtained:whether it is blood lipid or Hey,there is no significant correlation with osteoporosis.Conclusion1.In patients with diabetes mellitus and osteoporosis,lipid metabolism has a certain correlation with bone resorption and bone formation in the progression of diabetic osteoporosis.Controlling blood lipid may help reduce bone loss.2.In non-diabetic population,hyperlipidemia is associated with reduced bone formation.