| Background:At present,as China has entered the aging society,the incidence of male late-onset hypogonadism and osteoporosis has increased significantly.Nearly 40 years,for the rapid rise in the incidence of type 2 diabetes,China has become a “big country of diabetes”.Type 2 diabetes as a systemic metabolic disease on carbohydrate metabolism disorders,not only can cause diabetic retinopathy,diabetic nephropathy,peripheral neuropathy,microangiopathy,great vascular complications and hypogonadism,can further affect bone metabolism,leading to metabolic bone diseases such as osteoporosis.In recent years,with the rise of the theory of bone energy endocrine ring,it has been found that bone,as an endocrine organ,plays an important role in the regulation of energy metabolism and reproductive function.During bone metabolism,the synthesis and secretion of the beta collagen degradation products,osteocalcin,procollagen type I amino peptide and other bone factor have effects on glucose and lipid metabolism,insulin secretion,insulin sensitivity and sex hormone regulation in type 2 diabetic.At present,it is less related that studies on which,the possible mechanism and relationship between the level of bone metabolic markers and glucose and lipid metabolism as well as serum testosterone in male patients with type 2 diabetes.So,this paper mainly discusses the relationship between bone metabolic markers and glucose and lipid metabolism and serum testosterone level in male patients with type 2 diabetes mellitus.We try to provide new thought of diagnosis and treatment forpatients with type 2 diabetes.Objective:To investigate the correlation between bone metabolic markers and glucose and lipid metabolism in male patients with type 2 diabetes mellitus(T2DM),and to analyze the possible mechanism.Methods:The 114 cases of male T2 DM patients,114 aged between 19-80 years,were collected from October 2016 two to March 2017 in the Department of endocrinology in the First Hospital of Jilin University.The general data of patients were recorded including bone metabolism test(osteocalcin,beta collagen degradation products,type I collagen peptide,25-hydroxyl amino)the activity of vitamin D,D2,D3,Z value of lumbar BMD;body mass index(BMI= weight / height 2(kg/m2)),waistline,waist to height ratio,blood glucose,glycosylated hemoglobin,C peptide,liver function(aspartate aminotransferase,glutamate transferase,alkaline phosphatase),blood lipids(total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein),renal function(creatinine,urea nitrogen,uric acid),carbon dioxide combining power,urine ketone situation and testosterone were measured.We use MEDIX90 dual energy X-ray absorptiometry to detect Z value of lumbar spine bone mineral density.The obtained data were statistically analyzed by SPSS 19.0 and P<0.05 was used to indicate the difference of statistically significance.Results:(1)Osteocalcin(r=-0.196)has a negative correlation between blood glucose and triglyceride(r=-0.201).There was a negative correlation between beta collagen degradation products and waist to height ratio(r=-0.199)and Z(r=-0.311).Type I collagen amino peptide has a negative correlation(r=-0.212)with Z values of lumbar bone density.Alkaline phosphatase has negative correlation with lumbar vertebrae density Z and uric acid;Alkaline phosphatase was associated with glycosylated hemoglobin,blood sugar,total cholesterol,and both were statistically significant.There were positive correlations between osteocalcin,beta collagendegradation products as well as type I collagen amino peptide and alkaline phosphatase(r=0.212),which were statistically significant(P < 0.05).(2)On the basis of the correction of age and course of the disease,multiple linear regression analysis showed that there was a negatively correlated between blood glucose and osteocalcin,not affected by age and course of the disease.The triglyceride and osteocalcin did not have a linear relationship.It has a negative linear relationship which is independent of age and history of diabetes between beta collagen degradation products and waist / height,lumbar bone density of Z,which has statistical significance.Alkaline phosphatase and osteocalcin,beta collagen degradation products,type I collagen amino peptide have positive linear correlations(P < 0.05),and are not influenced by the age and course of diabetes.(3)The waistline associated with vitamin D2(r=0.200,p=0.033)is positive;blood glucose was negatively correlated with vitamin D3 and D,were statistically significant(P < 0.05);uric acid,creatinine,C peptide and Z value of lumbar BMD was positively correlated(P < 0.05),type I collagen amino extension peptide,beta collagen degradation products were negative related with Z value of bone mineral density of lumbar spine(P < 0.05).(4)On the basis of the correction of age and course of the disease,the results of multiple linear regression analysis is that the waist circumference,independent of the age and the course of diabetes,has a positive linear relationship with vitamin D2(P< 0.05);The results showed that there was a negative linear relationship between the degradation of βcollagen and the Z value of lumbar spine bone mineral density.The Z value of lumbar spine bone mineral density was positively correlated with creatinine.Conclusion:1.Osteocalcin was negatively correlated with triglyceride and blood glucose,and there was a negative correlation between beta collagen degradation products and waist to height ratio(r=-0.199)and Z(r=-0.311).’ Type I collagen amino peptide was negatively correlated with the Z value of lumbar spine bone mineral density.Alkaline phosphatase has negative correlation with lumbar vertebrae density Z and uric acid;Alkaline phosphatase was associated with glycosylated hemoglobin,blood sugar,total cholesterol,and both were statistically significant.2.Correlations between bone metabolism indicators: osteocalcin,beta collagen degradation products,I collagen amino peptide have positive linear relationships with alkaline phosphatase,and not affected by age and course of the disease.3.By adjusting the confounding factors of age and course of the disease,it was found that the relationship between blood glucose and osteocalcin was negatively,not affected by age and course of the disease.The waist circumference /height,Z value of lumbar spine bone mineral density have,independent of the age and the course of diabetes,negative linear relationships with the degradation of beta collagen.4.Blood sugar and vitamin D3,D were negatively correlated;uric acid,creatinine,C peptide was positively correlated with Z value of lumbar BMD.type I collagen amino peptide,beta collagen degradation products have negative correlations with bone mineral density of lumbar spine(P < 0.05).5.the relationship between waist circumference independent of age and diabetes process and vitamin D2 was positively linear;beta collagen degradation products and lumbar bone mineral density Z value showed a negative linear relationship.serum creatinine and lumbar bone mineral density Z value have a positive linear relationship not influenced by age and course.6.Testosterone was positively correlated with vitamin D2,but there was no linear relationship beacause of age and history. |
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