| Objective:To investigate the bone mineral density,bone markers and nail fold microcircu lation in postmenopausal women with type 2 diabetes mellitus(T2DM).MethodsChoose 128 cases of postmenopausal women who were hospitalized in the Dep artment of internal medicine of 309 Hospital from December 2014 to ~2016 in Ma rch,Among them,60 patients with type 2 diabetes mellitus,as the study group,ag ed 50-69 years,with an average age of 60.8 years,there were no patients with dia betes,and the control group was 50-69 years old with an average age of 59.8 year s.All patients underwent lumbar spine L2-L4 and left proximal femur and total hip density measured by dual energy X-ray bone densitometer.We measured the all pat ients’ s Nailfold Microcirculation by microcirculation detector(Xuzhou Zhonglian me dical instrument limited company),and measured their height,body weight,body m ass index(BMI),and record the admission of biochemical blood lipids,serum calci um,phosphorus,magnesium,fasting blood glucose.We easure the levels of B-ALP,TRAP5 b,PINP,25 hydroxy vitamin D in each group by Enzyme linked immunosor bent assay.Bone mineral density(BMD),biochemical markers,bone marker levels and nailfold microcirculation were compared between the two groups.Then all the s ubjects were divided into three groups according to bone mineral density,Then all subjects were divided into three groups according to bone mineral density,of which45 cases of osteoporosis,aged 51-69 years,mean age 61.5 years;osteopenia in 45 cases,aged 50-69 years old,the average age of 59.4 years;the normal bone densi ty in 38 cases,aged 50-69 years,mean age 58.8 years;We compare biochemical in dex,bone index,the level of microcirculation between the three groups and then judge whether there were statistically significant differences.ResultThere was no significant difference in age,height,body weight,total choleste rol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,serum magnesium and blood lipid levels between diabetic group and control group.There was also no significant difference in bone mineral density,25 hydroxyvitamin D an d PTH between the hip and lumbar vertebrae of the two groups of patients with 1-4.The fasting blood glucose,blood calcium level,TRAP-5b,nail fold microcirculati on score and total score in diabetic group were higher than those in the control gr oup,while the OC and ALP values were significantly lower than those in the contr ol group(P < 0.05).Pearson correlation analysis showed that the bone turnover ma rkers OC,TRAP,B-ALP were negatively correlated with BMD values(P < 0.05),e specially TRAP5 b and OC were well correlated with bone mineral density(BMD).All subjects were divided intothree groups(included osteoporosis group,osteopenia group and normal bone density)found that there is not statistically significant betw een the three groups in the general situation(age,height,weight,blood biochemical index)and Ca,P,Mg,GLU,TG,total cholesterol,HDL-C,LDL-C)and microcircul ation weighted integral value(P>0.05).There was a significant difference between O steoporosis group and bone density of the normal group in tartrate resistant acid ph osphonic acid enzyme(TRAP5b)and Osteocalcin(OC).The level of osteocalcin(O C)in osteopenia group and normal bone density group have statistically difference(P < 0.05).ConclusionAbnormalities of bone turnover markers in postmenopausal women with type2 diabetes mellitus may be a marker of diabetic osteoporosis.In the prevention of osteoporosis in patients with osteopenia,we should pay attention to the inhibition of osteoclast activity and the improvement of microcirculation. |
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