Study On The Influencing Factors Of Osteoporosis And Muscle Mass Reduction In Elderly Patients With Type 2 Diabetes Mellitus

Objective:(1)Investigate osteoporosis(OP)and muscle mass reduction in elderly T2 DM patients and compare the differences in osteoporosis and muscle mass reduction prevalence between elderly T2 DM and non-T2 DM patients.(2)By observing the differences of serum 25 hydroxyl vitamin D(25(OH)D)and other biochemical indicators in elderly T2 DM patients with osteoporosis or muscle mass reduction and other groups,the related influencing factors of osteoporosis and myotonia in elderly T2 DM patients were discussed.Methods: Subjects were divided into 280 cases of T2 DM group(observation group)and 135 cases of non-t2 dm group(control group).Bone Mineral Density(BMD)and T value diagnosis of osteoporosis were detected by Dual energy X-ray Absorptiometry(DEXA),and Bioelectrical Impedance Analysis(BIA).Skeletal muscle mass index(ASMI)was tested to determine muscle mass loss.Detection of serum 25(OH)D and Fasting glucose(FBG),triglyceride(TG),Total Cholesterol(TC),high-density Lipoprotein Cholesterol(HDL-C),low Density Lipoprotein((LDL-C),serum calcium(Ca),serum osteocalcin(OC),prealbumin(PAB),total bilirubin(TBIL),parathormone(PTH),glycosylated hemoglobin(Hb A1c),blood urea nitrogen(BUN),Uric acid(UA)levels.To compare the difference of the prevalence of osteoporosis,musclemass reduction,osteoporosiswith muscle mass reduction,serum 25(OH)D and other biochemical indexes between the observation group and the control group.Further observation group can be divided into elderly T2 DM group,the elderly T2 DM + less muscle group,the elderly T2 DM + loose bone group,less elderly T2 DM,loose bone and muscle groups,more elderly T2 DM group within each group compared with control group was statistically significant level difference of the indicators,mainly includes: 25(OH)D,PAB,TBIL,OC,PTH,Hb A1 c,HDL-C,LDL-C,TG,TC,UA,BUN.Results:(1)The incidence of osteoporosis,muscle mass reduction and osteoporosis combined with muscle mass reduction in the observation group was significantly higher than that in the control group(P<0.05).(2)Compared with the control group,25(OH)D,PAB,TBIL,OC and HDL-C levels in the observation group were also lower,and UA,PTH,Hb A1 c,LDL-C,TG,TC and BUN levels were higher.The difference between the two groups was statistically significant(P<0.05).(3)Serum level of 25(OH)D in the patients: in the elderly T2 DM group> in the elderly T2 DM with muscle mass reductiongroup> in the elderly T2DMwithosteoporosisgroup> in the elderly T2 DM with muscle mass reduction and osteoporosisgroup.(4)Pearson correlation analysis showed that BMD was positively correlated with ASMI(r=0.381,P<0.05).25(OH)D was positively correlated with BMD(r=0.703,P<0.05)and ASMI(r=0.536,P<0.05).PAB was positively correlated with ASMI(r=0.192,P<0.05).UA was positively correlated with ASMI(r=0.177,P<0.05).TBIL was positively correlated with BMD(r=0.376,P<0.05)and ASMI(r=0.227,P<0.05).OC was positively correlated with BMD(r=0.563,P<0.05)and ASMI(r=0.404,P<0.05).PTH was negatively correlated with BMD(r=-0.669,P<0.05)and ASMI(r=-0.527,P<0.05).Hb A1 c was negatively correlated with BMD(r=-0.485,P<0.05)and ASMI(r=-0.320,P<0.05).25(OH)D was positively correlated with PAB(r=0.170,P<0.05),UA(r=0.137,P<0.05),TBIL(r=0.471,P<0.05)and OC(r=0.595,P<0.05).25(OH)D was negatively correlated with PTH(r=-0.738,P<0.05)and Hb A1c(r=-0.499,P<0.05).(5)Logistic regression analysis showed that 25(OH)D was correlated with musculoskeletal pine,with OR value(OR=0.043,P=0.0447),25(OH)D,UA,Hb A1 c were correlated with sarcoidemia,with OR value(OR=0.805,OR=0.993,OR=1.095),and P values(P<0.000 1,P= 0.003 6,P=0.001 5).Conclusion:(1)The incidence of osteoporosis and decreased muscle mass in elderly T2 DM patients is higher than that in normal elderly population.(2)Vitamin D is a common risk factor for osteoporosis and muscle mass reduction in elderly patients with type 2 diabetes.The lower vitamin D is,the more serious osteoporosis and muscle mass reduction is in elderly patients with type 2 diabetes.(3)25(OH)D was correlated with osteoporosis in elderly T2 DM patients;Levels of 25(OH)D,UA and Hb A1 c are associated with reduced muscle mass in elderly T2 DM patients.