| Objective:To analyze the correlation between serum uric acid levels and bone mineral density and bone metabolic markers in patients with type2 diabetes mellitus.Methods:595 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University from September 2016 to November 2019 were selected.Basic data of patients were collected,and serum uric acid,creatinine(Cr),alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),calcium(Ca),phosphorus(P)were detected,magnesium(Mg),blood lipids,parathormone(PTH),25-hydroxyvitamin D3(25(OH)D),calcitonin(CT),bone alkaline phosphatase(BALP),osteocalcin(OC),procollagen type I N-terminal propetide(PINP)and collagen type I hydroxyl telopeptide beta degradation product(?-CTX)were measured,and bone mineral density of the left femoral neck,lumbar spine(L1-4)and hip was measured by dual-energyX-ray absorptiometry(DXA).(1)Analysis of baseline characteristics of patients of different genders;(2)according to the level of serum uric acid,the patients were divided into U1 group(sua < 360 ? mol / l),U2group(360 ? sua < 420 ? mol / l),U3 group(420 ? sua ? 540 ? mol / l),U4 group(sua > 540 ? mol / l).The differences of general data,BMD and bone metabolic indexes between groups were compared.(3)Pearson/Spearman correlation analysis and multiple regression analysis were used to determine the relationship between SUA level and BMD of lumbar spine,femoral neck,total hip and bone metabolic indexes.Results:(1)SUA,Cr,body weight,25(OH)D,lumbar BMD,fem oral neck BMD and total hip BMD were higher in males than femal es,and blood P,PTH,?-CTX,OC,PINP and BALP were lower tha n females(all P < 0.05).(2)There were significant differences in SU A,Cr,estimated glomerular filtration rate(eGFR),TG,PTH and 25(OH)D between groups in women(P < 0.05).There were significant d ifferences in SUA,Cr,eGFR,HDL-C,lumbar BMD,total hip BMD,PTH and 25(OH)D among male groups(P<0.05).BMD was highest i n the U2 group and lowest in the U4 group,both male and female.(3)The results of correlation analysis showed that serum uric acid lev el was positively correlated with BMD of lumbar spine,femoral neck and total hip in female U1-U2 group,but only in U1 group was st atistically significant(r = 0.151,r = 0.187,r = 0.205;all P < 0.05).In the U3-U4 group,serum uric acid was negatively correlated with BMD of lumbar spine,femoral neck and total hip,but only in the U4 group,the negative correlation with BMD of femoral neck was stat istically significant(r =-0.336;P < 0.05).In U4 group,SUA was po sitively correlated with 25(OH)D and BALP(r=0.546,r=0.458;all P<0.05).In male U1-U2 group,serum uric acid was positively correlated with BMD of lumbar spine,femoral neck and total hip,but only th e positive correlation with BMD of lumbar spine was statistically sig nificant(r = 0.205,r = 0.262;all P < 0.05).In the U3-U4 group,ser um uric acid was negatively correlated with multisite BMD,but the differences were not statistically significant.In U3 and U4 groups,SU A was negatively correlated with CT(r=-0.446,r=-0.297;all P<0.05).In women,after adjusting for confounding factors,SUA was positivel y correlated with BMD of all sites and 25(OH)D at normal serum ur ic acid level,and negatively correlated with BMD at all sites at high uric acid level,but not statistically significant,and positively correla ted with BALP.In men,after adjusting for confounding factors,SUA was positively correlated with lumbar BMD and PTH at normal ser um uric acid levels,and negatively correlated with BMD at all sites at high uric acid levels,but not statistically significant,and negativel y correlated with CT.Conclusion: In patients with type 2 diabetes,a slightly higher serum uric acid level within the normal physiological range is more li kely to maintain bone mass,especially for lumbar BMD.The correlati on between serum uric acid and bone metabolic markers was differen t in different gender and levels,and the normal high SUA may playe d a protective role on bone metabolism. |
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