| Objective To investigate the changes in bone mineral density (BMD), the incidence and related risk factors of complicated OP in patients with type 2 diabetes mellitus (T2DM).Methods 248 patients of T2DM hospitalized in Second Xiangya Hospital from Jan 2005 to Jan 2007 were involved in this retrospective research. The clinical informations of the patients were collected including gender, age, menopausal age of women, weight, height, waist circumference,hip circumference and the blood biochemical indices containing of fasting blood glucose (FPG), cholesterol (CHOL), triglyceride (TG),low-density lipoprotein (LDL),calcium, phosphorus, and glycosylated hemoglobin (HbAlc),fasting insulin (FINS).Parameters of BMD such as T value,L1-L4 lumbar spine,anteroposterior spine (L1-4), left side of Ward’s zone of proximal femoral,neck and total hip (T-hip) were also attained.All statistical analyses were performed using SPSS 14.0.According to different research purposes and types of data, t test,χ2 test and multiple stepwise regression analysis were used to analyze the related factors of BMD of various sites in the T2DM patients with OP.P<0.05 (2-tailed) was considered significant difference.Results 1.General conditions.All subjects were grouped by gender (M-DM for male,F-DM for female).The age,BMI, WHR, duration, HbAlc, FPG, TG, CHOL, LDL, CR, calcium, phosphorus, FINS and prevalence have been found no significant differences between two groups (P>0.05).There were significant differences in BMD at lumbar spine, femoral neck, hip and the whole Ward’s triangle between two groups (P<0.05).Whether male or female, OP group have older age,longer duration, higher HbAlc,lower BMD in all sites and lower BMI than those of NOP groups.The female OP group has longer menopause period and the male OP group has higher WHR than that of NOP group (P<0.05).2.The distribution of BMD of T2DM patients according to the complications,BMI and duration. The relation between complications and BMD:All subjects were divided into five groups such as diabetic without complications (NC), diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN), diabetic nephropathy (DN), and diabetic merging two and more complications.In M-DM patients,only BMD value of L1 in DN group was significantly lower than that in NC group (P<0.05).In F-DM patients,only the BMD of Ward’s region in DN group was significantly lower than that in NC group. Other BMD of lumbar spine and hip were not significantly different between each group whether male or female (P>0.05).OP Prevalence has not been found significant difference between male or female patients with various complications (P>0.05).Relation between BMI and BMD:All subjects were divided into low weight group (BMI≤18.5),normal group(18.5<BMI<25)and obesity group (BMI>25).The age, duration, HbAlc have no significant difference with different BMI for both male and female (P>0.05).In M-DM patients, Except L3 and L1-4,the BMD of remaining lumbar spine,Neck, Ward’s and T-hip in the normal and obese group were significantly higher than those in low weight group (P<0.05).In F-DM patients, Except L1,the BMD in other sites of the normal and obese group were significantly higher than those in low weight group (P<0.05).For both male and female patients, there was significant difference in OP prevalence between different BMI groups.The low weight patients have higher OP prevalence than that of normal while normal group is higher than that in obesity patients (P<0.05).Relation between duration of T2DM and BMD:Whether male or female, there are no statistically difference in age, menopause period (women), BMI, HbAlc, the BMD in lumbar spine and hip, and OP prevalence with different duration of diabetes (P>0.05).3.Related factors of the BMD of T2DM patients with OP.Multiple linear regression analysis show that the major factors affecting BMD of lumbar spine and hip are age, BMI, HbAlc, and menopausal period in T2DM patients with OP.Duration of diabetes and complications of T2DM are not independent factors of the BMD in lumbar spine and hip.Conclusions 1.The patients in group of T2DM complicated with OP have older age,longer duration of disease, lower BMI, higher glycosylated hemoglobin, and lower BMD in various sites than that in the NOP group.2.BMD and the OP prevalence of T2DM patients are not found related to the state of diabetes complications such as DN, DR, DPN.3.Age,BMI,HbAlc and menopausal period of women are the main independent factors of BMD values in T2DM patients with OP, and duration, complications of T2DM are not found being independent factors of the BMD in lumbar, neck and ward’s sites. |
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