| Objective: In this study,through the observation of the middle-aged and elderly(age ≥ 45)type 2 diabetes in our hospital Objective to analyze the relationship between carotid atherosclerosis and bone metabolism level and the related risk factors affecting bone metabolism level,and to explore the tendency of low bone mass in T2 DM patients with carotid atherosclerosis of different TCM syndromes,so as to provide clinical basis for early prevention and treatment of diabetic osteoporosis.Methods: A total of 181 patients with T2 DM admitted to The First Affiliated Hospital of Guangxi University of traditional Chinese Medicine Hospital from June 2019 to September 2020 were retrospectively analyzed,including82 males and 99 females.All subjects were measured bone mineral density(BMD)by quantitative computed tomography(QCT)Color Doppler ultrasound was used to detect carotid artery and its intima-media thickness(CIMT).Patients were divided into normal bone mass group(BMD ≥ 120mg/ cm3 and t value ≥-1.0SD)and low bone mass group(BMD < 120 mg / cm3 or T value <-1.0SD)according to BMD SD,including osteopenia and osteoporosis),at the same time,according to the formation of carotid atherosclerosis(CAS),they were divided into CAS group and non CAS group,and the basic information and related metabolic indicators of the patients were recorded,and the patients were divided into TCM syndrome differentiation,and the related factors were statistically analyzed.Results: 1.The course of diabetes,glycosylated hemoglobin(hb1ac),high density lipoprotein cholesterol(LDL-C)and uric acid(uric acid)in CAS group The number of smokers in CAS group was more than that in non CAS group;the BMD value of lumbar spine and t value of hip joint in CAS group were lower than those in non CAS group,the differences were statistically significant(P < 0.05).2.The incidence of low bone mass in CAS group was significantly higher than that in non CAS group(P < 0.05).3.CIMT was correlated with age,duration of diabetes,hb1 ac,fasting blood glucose(FBG)and 25 hydroxyvitamin D(P < 0.05).CIMT was negatively correlated with lumbar BMD and hip t value in middle-aged and elderly patients with T2DM(P < 0.001).4.Multivariate logistic regression analysis was conducted with low bone mass as the dependent variable.The results showed that female,old age,longer course of diabetes and carotid atherosclerosis were the risk factors of low bone mass in middle-aged and elderly patients with T2 DM,and increased BMI was the protective factor of low bone mass in middle-aged and elderly patients with T2DM(P < 0.05).5.According to the bone mineral density,T2 DM patients with carotid atherosclerosis were divided into normal bone mass group and low bone mass group.The results showed that in the low bone mass group,the number of patients with liver kidney yin deficiency syndrome(30%)and qi stagnation and blood stasis syndrome(30%)was the most,followed by phlegm dampness syndrome(20%)and lung stomach heat syndrome(20%).The number of patients with Yin deficiency of liver and kidney in low bone mass group was more than that in normal bone mass group,and the difference was statistically significant(P < 0.05).6.In T2 DM patients with carotid atherosclerosis,the lumbar BMD value of liver kidney yin deficiency group was lower than that of lung stomach heat excess group and phlegm dampness resistance group,the difference was statistically significant(P < 0.05).The T value of hip joint in liver kidney yin deficiency group was lower than that in phlegm dampness middle obstruction group,and the difference was statistically significant(P < 0.05).7.Binary logistic regression analysis showed that there was a close relationship between liver kidney yin deficiency syndrome and low bone mass in T2 DM patients with carotid atherosclerosis.(P<0.05)。Conclusions: 1.The formation of carotid atherosclerosis is closely related to the occurrence of low bone mass in elderly patients with T2 DM.2.Female,old age,long course of diabetes and carotid atherosclerosis are the risk factors of low bone mass in middle-aged and elderly patients with T2 DM.3.In T2 DM patients with carotid atherosclerosis,patients with liver kidney yin deficiency syndrome are more likely to have low bone mass. |
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