Research On Relationship Between Serum Uric Acid As Well As Bilirubin And Osteoporosis In Elderly Patients With Type 2 Diabetes Mellitus

Objective:To investigate the relationship between serum uric acid as well as bilirubin and osteoporosis in patients with type 2 diabetes mellitus,so as to identify potential influencing factors of osteoporosis in diabetic patients,and to provide theoretical basis for the prevention of osteoporosis.Method:From February 2017 to February 2018,246 T2 DM patients older than 60 y in Department of endocrinology in the first hospital of Jilin University were enrolled,of which 97 were male and 149 were female.The average age was(67.4 ± 6.3)years,and the history of diabetes was(13.1 ± 6.2)years.and these patients were accepted dual-energy X-ray absorptiometry(DEXA)to test two parts of the bone mineral density,including the lumbar spine and Bilateral femur neck bone mineral density.According to the diagnostic criteria for osteoporosis of WHO,bone mineral density status was divided into normal bone mass group(T≥-1),osteopenia group(-1<T<-2.5)and osteoporosis group(T≤-2.5)according to T level,and these patients above were divided into 3 groups: normal bone mass group(n=92),osteopenia group(n=77)and osteoporosis group(n=77).The parameters such as the age,gender,height,diabetes duration,height,weight,the body mass index(BMI)and other related information were recorded,FBG,FCP,HbAlc,PTH、TSH、FT3、FT4、ALT、ALP、TBil、TC,TG,LDL-C、HDL-C,Cr、SUA、Ca、P、25-(OH)VitD were measured.The measurement data of normal distribution expressed by(?x 士 SD)was analyzed through SPSS 22.0.The skewed distribution data was represented by median(four interval),and the counting data was expressed by frequency The measurement data obey normal distribution and homogeneity compared with single factor analysis of variance.Comparison between the two groups using LSD method,The measurement data does not obey the normal distribution homogeneity of variance using non parametric test count data was analyzed byX2 test,two bivariate normal distribution variables using liner correlation analysis,and the non normal distribution variables using Spearman rank correlation.The logistic regression was used for the multi-factor analysis,and the formula OR=exp(β)was used to calculate the value of OR,P<0.05 was considered to bestatistical significance.Results:(1)The gender,diabetes duration,FCP,BMI,ALP,SUA,TBIL among three groups shows the statistical difference(X2=22.53,7.461,9.44,F=7.461,14.64,17.87,8.54,P<0.05).FBG,HbA1 c,PTH,TSH,FT3,FT4,ALT,TC,TG,LDL,HDL,Cr,Ca,P,25-(OH)VitD have no statistical difference in three groups(P>0.05).(2)Conducting the liner correlation between age,duration of diabetes,BMI,HbA1 c,FCP,TBIL,SUA and fasting blood glucose with bilateral femoral neck and lumbar spinal L1-4 average bone density,the result expresses:the positive correlation exists between the BMI,SUA,TBil and the BMD of the femoral neck and the average lumbar spine(L1-L4)r=0.293,0.27,0.37;P<0.01),the positive correlation exists between the FCP and the BMD of the average lumbar spine(L1-L4)(r=0.16,P=0.02),the negative correlation exists between the diabetes duration and the BMD of the femoral neck and the average lumbar spine(L1-L4)(r=-0.14,-0.13,P=0.04)the negative correlation exists between the age and the BMD of the femoral neck(r=0.186,P=0.01).(3)According to the bone condition of patients with type 2 diabetes,divides them into diabetics normal bone mass group,osteopenia group and osteoporosis group,regarding as a dependent variable,based on the single factor analysis,and screens gende,ALP,BMI,TBIL,FCP,SUA,FT4,and then the 7.0 index regarded as independent variable process into Logistic regression analysis,eventually gender,BMI,FCP,ALP,SUA,TBIL,Cr associated with osteoporosis(OR=6.271,0.811,0.179,1.024,0.871,0.990,P<0.05),among them above,the ALP,Cr are considered as risk factors of osteoporosis(OR=1.024,1.073,P<0.05),compared with men,female has a higher risk of osteoporosis,which is same to be a risk factor;BMI,FCP,SUA,TBil are considered as protective factors of osteoporosis(OR=0.811,0.179,0.990,0.871,P<0.05).Conclusion:1.The bone mineral density in type 2 diabetic patients show independent positive correlation with BMI,fasting C peptide,SUA,TBil in the range of physiological concentration and independent negative correlation with ALP.2.The bone mineral density in type 2 diabetic patients increased with the increases of serum uric acid and bilirubin,Blood uric acid and bilirubin in physiological range may be a protective factor for osteoporosis.Women are an independent risk factor for osteoporosis.