| Objective: With the development of people's life quality and the extendability of natural life, the morbidity of the diabetic mellitus and the osteoporosis is increasing. Recent studies have demonstrated that an elevated risk of osteoporosis and fractures in diabetic subjects. The presence of osteoporosis in type 1 diabetes seems to be a reliable evidence. On the other hand, there is still some controversy about the risk of osteoporosis in type 2 diabetes. Although the pathogenic mechanisms are not fully understood, the reason maybe the disturbtion in diabetic bone metabolism: Hyperglycemia bring on osmosis diuresis, which result in calcium and phosphorus loss though the urine by bone resorption increasing; the decrease of estrogen level reduced the 1-α-hydroxylase bioactivity, calcium reabsorbed by kidney falling, which could bring abnormal bone turnover and bone loss; the decrease of calcitonin matrix especially the function of storage falling increased the bone absorption by enhancing the osteoclastic activity. In elder diabetic patients with complications, which bone formation is declining; cytokines such as the abnormity of IGF system and IL-6 disturb the balance of the cytokines'network in bone system. For those reason, the morbidity of diabetic osteoporosis is increasing. Our investigation indicated that 54.3% patients with type 2 diabetes mellitus have osteoporosis measured by DEXA, and BMD was also affected by many factors such as genes, measurement apparatus, site, etc. Due to the hyperinsulin and obesity etc, the measured result of bone mineral density (BMD) in type 2 diabetic patients may increased, decreased, or was normal. The purpose of this study was to evaluate the change of BMD which measured by DEXA in T2DM patients and the relationship between osteoporosis risk factors and BMD, in order to find the related factors and the pathogenic mechanisms in type 2 diabetic osteoporosis. Methods: In this study, 57 subjects (aged 50~70 years, 22 men and 35 women) with type 2 diabetes mellitus (defined by 1999 WHO criteria), 61 healthy non-diabetic subjects (20 men and 41 women) were made as control group. All subjects were evaluated for BMD at L(1)~L(4) lumbar vertebrae and at the femur (neck, trochanter, InterTro and total) by DEXA (dual energy X-ray absorptiometry). The patients' diabetic duration, years since menopause (YSM), FBG, PBG, et al were recorded, and these data were evaluated for any relationship in respect to BMD measurements. Characteristics of subject obtained: ①BMD were measured by OSTEOCORE 3 made in MEDI LINK (France). ②FBG, PBG were measured by GLUCOTREND2 (Roche Co. Switzerland). ③cholesterol (TT),triglyceride (TG),highdensity lipoprotein (HDL),etc were measured by AU2700 (OLMPUS Co. Japan). ④hemoglobin A1c in blood and albumin/creatinine ratio in urine were determined by DCA2000+(Bayer Co. Germany). ⑤fasting plasma insulin (FINS), were measured with radioimmunoassay. serum level of estradiol (E2),luteinizing hormone (LH) and follicle stimulating hormone (FSH) were determined by chemiluminescence technique. ⑥The patients'high and weight were recorded, body mass index was counted. Results 1 There were no significant different in age, sex, BMI, between type 2 diabetes and normal control and also YSM in female. 2 BMD in diabetic group was found to be decreased at all positions, moreover at the L1 BMD in man and BMD of the right femur trochanter, InterTro and total in women were significantly lower (P<0.05). 3 In diabetic group, there were lower BMD in women than those in men, especially in L1~L3 and left femur neck (P<0.05). 4 The ratio of osteoporosis in women is 62.8% which is higher than in man (40.9%). 5 In diabetic group, compared with the osteoporotic patients and non-osteoporotic patients, the diabetic duration was significantly longer than that in non-osteoporotic patients (P<0.05), BMI and FINS were significantly higher than those...
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