Type 2 Diabetes Mellitus And Osteoporosis Of Syndromes And Risk Factors

Purpose：To screen the ratio of osteoporosis(OP) in hospitalized patients withtype2diabetes(T2DM) in the endocrinology department of The First AffiliatedHospital of Liaoning University of Chinese Medicine from Jun to Sep,2012,andinvestigate the distribution regularity of TCM syndromes,analyse relative riskfactors to provide theoretical basis for early prevention of diabeticosteoporosis(DOP).Material and method：By using France Osteospace ultrasound bone density meterfor calcaneus,we screened wether OP was existed in selected patients,and wedivided them into two groups:OP group and non-OP group.We calculated the ratioof patients with OP in the selected patients.Then we separated the selectedpatients by TCM syndrome and counted the distribution regularity of TCMsyndromes;and compared the differences in sex, age, waist circumference,bodymass index(BMI),the course of diabetes,mean of24-hours ambulatory bloodpressure,glycated hemoglobin,fasting plasma glucose,fastinginsulin(FIns),fasting C peptide,mean of three microalbuminuria,serumcalcium(Ca),phosphorus,liver function,blood uric acid,blood lipid.After thatwe made two classification logistic regression analysis to explore the riskfactors of OP in T2DM.Results：Among the508selected patients with T2DM,237cases were belong tohyperactivity of heat due to Yin deficiency syndrome,247cases were belong toboth Qi and Yin deficiency syndrome and24cases were belong to both Yin andYang deficiency syndrome.The OP rate was35.04%among all the selectedpatients.The incidence of these178patients with DOP in each TCMsyndrome:Hyperactivity of heat due to Yin deficiency syndrome was24.05%;bothQi and Yin deficiency syndrome was41.7%;both Yin and Yang deficiency syndromewas75%.The distribution regularity of TCM syndromes:Hyperactivity of heat dueto Yin deficiency syndrome contained57cases(32.02%);both Qi and Yin deficiencysyndrome contained103cases(57.87%);both Yin and Yang deficiency syndrome contained18cases(10.11%).Compared with those in non-OP group,patients in OPgroup had older age,longer disease course,lower BMI,higher FIns,lower fastingC peptide, higher mean of three microalbuminuria,lower Ca,AST,ALT,GGT and higherHDL-C,which indicated the differences were statistically significant(P<0.05or P<0.01).The two classification logistic regression analysis showed that therisk factors of OP were low BMI,fasting C peptide and AST,high microalbuminuria,FIns and advanced age.Conclusion：This observation suggested that the rate of OP in T2DM patients issignificantly higher than that in normal population reported in literature;Amongthe selected patients,those pertaining to hyperactivity of heat due to Yindeficiency syndrome and both Qi and Yin deficiency syndrome are more common thenthose pertaining to both Yin and Yang deficiency syndrome.With the developmentof the course of T2DM,the ratio of DOP becomes increasingly higher.The riskfactors related to T2DM complicated with OP are advanced age,poor isletfunction,low BMI,low AST and diabetic nephropathy.