Study On The Relationship Between Osteoporosis And Microvascular Complications In Patients With Type 2 Diabetes Mellitus

ObjectiveTo observe the difference in bone mineral density between type 2 diabetic patients with different kinds of microvascular complications in men,premenopausal and postmenopausal women,to explore the relationship between osteoporosis in patients with type 2 diabetes with microvascular complications.Methods515 cases of type 2 diabetic patients hospitalized in the department of endocrinology were collected between September 2015 to August 2016 from Changzhou Second People’s Hospital affiliated to the Nanjing Medical University.According with microvascular complications(diabetic nephropathy,diabetic retinopathy,diabetic peripheral neuropathy)cases.Patients are divided into four subgroups,Group A means without microvascular complications.Group B means any 1 microvascular complications,Group C means 2 kinds of microvascular complications,and Group D means there are 3 kinds of microvascular complications.Using dual energy X-ray absorptiometry to measure the bone mineral density of lumbar and femoral neek,collecting lumbar and femoral neck T value data of the type 2 diabetic patients.The changes of lumbar and femoral neck T values in patients with type 2 diabetes mellitus combined with several microvascular complications and those without microvascular complications were compared between men and non menopausal women and postmenopausal women.Results1.The duration of diabetes and age in osteoporosis group were higher than those in non osteoporosis group(P<0.05).There was no significant difference in fasting blood-glucose,fasting C peptide and HbAlc between the two groups(P>0.05).2.The incidence of diabetic peripheral neuropathy in osteoporosis group was significantly higher than that in non osteoporosis group(P<0.05).There was no significant difference in the incidence of diabetic nephropathy and diabetic retinopathy between the two groups(P>0.05).3.A1,B1,C1 and D1 were divided into four groups,and the lumbar T values of 221 male patients with type 2 diabetes mellitus were not significantly different between the two groups.The T value of femoral neck between four groups of patients with type 2 diabetes mellitus,A1,B1,C1 and D1 was significantly different(P<0.05),and the bone mineral density of group D1 was the lowest.A2,B2,C2 and D2 were divided into four groups to study and compare the T value of the lumbar spine(P=0.178>0.05)and the T value of the femoral neck(P=0.586>0.05)in 199 postmenopausal women with type 2 diabetes mellitus,and there was no significant difference between them.Four groups marked A3,B3,C3 and D3 were studied in 95 cases of premenopausal women with type 2 diabetes,respectively,compared with group A3,group D3 had significant difference between the T values of lumbar spine and femoral neck(P<0.05).The T values of lumbar spine and femoral neck of group B3,group C3 and group A3 had no significant difference(P>0.05).Conclusion1.Osteoporosis is closely associated with microvascular complications in patients with type 2 diabetes mellitus.Diabetic peripheral neuropathy may be one of the important causes of osteoporosis.2.Compared with those patients without microvascular complications,the bone mineral density of patients with microvascular complications decreased in men and premenopausal women with type 2 diabetes,with the increase of microvascular complications,and bone mass loss more severe.There might be no difference of bone mineral density between postmenopausal women with and without microvascular complications in type 2 diabetes mellitus.