| Objectives In this study,we tried to investigate the value of bone strength geometric and mechanical indicators in evaluating Osteoporosis of type 2 diabetes,analyze the risk factors affecting bone strength of type 2 diabetes and investigate the correlation between body composition and bone density and bone strength in type 2 diabetes.MethodsThis was a retrospective observational study.342 patients with T2 DM were enrolled,including 134 males and 208 females.Body composition analysis was carried out in 75 cases,including 39 males and 36 females.Clinically relevant parameters of height,weight,body mass index were collected.All biochemical indicators including blood calcium(Ca),blood phosphorus(P),blood alkaline phosphatase(ALP)and fasting plasma glucose(FBG)were measured.Glycated hemoglobin was measured by HPLC from Bio-Rad.Serum VD,BGP(N-terminal),PINP,B-CTX and PTH were measured by using Roche ECL meter.Bone density was analyzed by the US Hologic Discovery-A DXA,the geometric index of bone strength of the neck of femur was obtained by hip structural analysis(HSA).The geometric index of bone strength including cross-sectional area(CSA),cortical thickness(CT),and buckling stress ratio(BR).Data comparison was performed using analysis of variance or non-parametric test.The relationship and influencing factors among indicators were analyzed using linear correlation analysis or multiple stepwise regression analysis.Results1.The prevalence of osteoporosis in T2 DM patients in this study was 42.11%,of which27.61% in male and 51.44% in female.The prevalence of osteoporosis was significantly different between male and female groups,suggesting that the prevalence of osteoporosis in female group was higher than that in male group.2.Bone strength geometric and mechanical indexes between different bone mass groups.There were significant differences in cross sectional area(cross-sectional area of neck,CSA-NN),cortical thickness(cort thick of neck,CT-NN)and flexion stress ratio(buckling stress ratio of neck,BR-NN)between osteoporosis group,osteopenia group and normal bone mass group.0.0.000).and the prevalence of osteoporosis among different bone strength geometric mechanical index groups was also significantly different(P=0.000,0.000,0.000).3.The differences in age,body mass index(body mass index,BMI),alp,bone metabolism index,and lean body mass index(percentage of lean mass,LMI)were statistically significant in 3.T2 DM patients with different bone mass groups.4.The BMD and risk factors were analyzed in pairs.The LMI of body composition and BMD were FN-BMD(r =0.542).p=0.000),mean bone mineral density(lumbar mean bone mineral density,LS-BMD)of L1-L4 vertebral bodies(r =0.477,p=0.000)were statistically significant.BMD was negatively correlated with age and ALP、BGP、PINP、B-CTX and positively correlated with BMI、VD、LMI.5.Geometric mechanical index of bone strength was analyzed by pairwise correlation analysis with risk factors CSA-NN which was positively correlated with LMI in body composition(r =0.594,p=0.000)and negatively correlated with LMI in body composition(r-0.313,p=0.006).the geometric mechanical indexes of bone strength were negatively correlated with age and ALP、BGP、PINP、B-CTX,and positively correlated with BMI、VD、LMI.6.Multiple linear regression results showed that age,BMI、BGP were the risk factors affecting FN-BMD,and age and BMI、Hb A1 c were the risk factors affecting LS-BMD.7.Multiple linear regression results show that LMI are risk factors affecting CSA-NN、CT-NN,and age and BMI are risk factors affecting BR-NN.age,BMI、BGP、PINP、UA is the risk factor affecting the CSA-NN,age,BMI、BGP、ALP is the risk factor affecting the CT-NN,age,BMI、BGP、ALP、UA is the risk factor affecting the BR-NN.ConclusionThis study suggested that bone strength geometric and mechanical indicators in T2 DM patients are associated with bone mineral density and can be used as indicators to assess bone strength.T2 DM geometric and mechanical indexes of bone strength in patients were related to age,BMI、VD、bone conversion index and lean body mass index in body composition.bone density in T2 DM patients was associated with lean body mass index in body composition,and also with age,BMI、VD、bone turnover index. |
