Relationship Between Carotid Atherosclerotic Plaque And Bone Mineral Density And Hip Geometry Parameters In Patients With Type 2 Diabetes Mellitus

Background:Patients with type 2 diabetes have a significantly increased risk of osteoporotic fractures,and bone mineral density(BMD)underestimates this risk.The formation of atherosclerotic plaque is associated with the pathophysiological process of osteoporosis.Clinical studies have shown that the formation of atherosclerotic plaque in patients with type 2 diabetes can lead to an increased risk of fracture,suggesting that the formation of carotid atherosclerotic plaque may be one of the risk factors of osteoporosis in patients with type 2 diabetes.Objective:To explore the correlation between carotid atherosclerotic plaque area and BMD and hip geometry parameters in patients with type 2 diabetes mellitus.Methods:561 patients with type 2 diabetes admitted to the Third Affiliated Hospital of Southern Medical University from 2014 to 2019 were included,and they were divided into carotid atherosclerotic plaque group and non-plaque group by gender.Patients’ basic data,biochemical indicators,carotid ultrasound data,BMD,and hip geometric parameters were collected.Differences in clinical data between groups were compared.The correlation between BMD,hip geometry parameters and each factor was analyzed.Multiple linear regression was used to analyze the relationship between plaque area and BMD hip geometric parameters.Binary Logistic regression analysis of the influencing factors of osteoporosis in men over 50 years old and postmenopausal women with type 2 diabetes mellitus.Results:1.In postmenopausal women with type 2 diabetes mellitus,WTR-BMD,TR-BMD,TH-BMD,CSA,CSMI and Z were all lower in the carotid atherosclerotic plaque group than in the non-plaque group,while the bucking ratio(BR)was higher than that in the non-plaque group,and the proportion of osteoporosis patients was higher than that in the non-plaque group.The results of correlation analysis showed that after controlling for other influencing factors,the total patch area was still negatively correlated with TR-BMD,TH-BMD,CSA,CSMI,Z,and positively correlated with BR.Multiple linear regression confirmed that the carotid plaque area was the main influencing factor of TR-BMD,TH-BMD,CSA,CSMI,Z and BR.Logistic regression analysis showed that total plaque area was a risk factor for osteoporosis in postmenopausal women with type 2 diabetes and BMI was a protective factor.2.There were no statistically significant differences in bone mineral density,hip geometry parameters and the proportion of patients with osteoporosis between the carotid atherosclerotic plaque group and the non-plaque group in male patients with type 2 diabetes over the age of 50.Correlation analysis showed that there was no correlation between total carotid atherosclerotic plaque area and bone mineral density and hip bone geometric parameters.Multiple linear regression showed that age and ALP were risk factors for decreased BMD and hip geometric structure performance in male patients with type 2 diabetes over 50 years old,and BMI was a protective factor.Logistic regression analysis showed that age was a risk factor for osteoporosis in male patients with type 2 diabetes over 50 years old,and BMI was a protective factor.Conclusion:1.In postmenopausal patients with type 2 diabetes,the formation of atherosclerotic plaques in the neck is a risk factor for the decrease of hip BMD and the complication of osteoporosis.The larger the plaque area,the worse the BMD and the geometric structure performance of the hip.2.No association was found between carotid atherosclerotic plaque and bone mineral density or hip bone geometry in men over 50 years of age with type 2 diabetes.Age is a risk factor for osteoporosis in men over 50 years of age with type 2 diabetes.3.BMI is a protective factor for osteoporosis in men over age 50 and postmenopausal women with type 2 diabetes.