| Objective:To investigate the characteristics of systemic immune inflammation index(SII),neutrophils-lymphocytes ratio(NLR),monocytes-lymphocytes ratio(MLR),platelet-lymphocyte ratio(PLR)in patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP),and their correlation with bone mineral density(BMD)was analyzed,to provide a theoretical basis for early treatment of osteoporosis.Methods:Two years since the October 2018 to see a doctor in The First Hospital of Shanxi Medical University endocrinology clinic or hospital patients screened,in strict accordance with the exclusion criteria,the final selection of osteoporosis patients 98 cases,187 patients with type 2 diabetes,in which 75 cases of type 2 diabetes mellitus and osteoporosis,merge osteopenia 58 cases,bone mass normal 54 cases as the research object,collect basic data of patients,and to detect theβ-caroxyl terminal peptide(β-CTX),fasting blood glucose(FPG),Fasting serum insulin(FINS),glycosylated hemoglobin(Hb Alc),type I procollagen N-terminal proeptide(PINP),lymphocyte count,neutrophil count,monocyte count,and platelet count,parathyroid hormone(PTH),25(OH)D.Homeostasis model assessment of insulin resistance(HOMA-IR),Homeostasis model assessment of β-cell(HOMA-β),NLR,MLR,PLR,SII were calculated.Lumbar L1-L4 BMD was measured by dual-energy X-ray.(1)according to the patient’s bone mineral density and blood glucose levels divided the patients into 4 groups: osteoporosis group,type 2 diabetes mellitus with osteoporosis group(T1),type 2 diabetes mellitus with osteopenia group(T2),Type 2 diabetes with normal bone mass group(T3).The differences in NLR,MLR,PLR,SII and other indicators between the latter three groups were compared to see if there was statistical significance,and the differences in each indicator between the former two groups were also compared to see if there was statistical significance.(2)Spearman correlation analysis was used to determine the correlation between NLR,MLR,PLR,SII and BMD and bone turnover indexes in patients with type2 diabetes mellitus and osteoporosis.(3)The receiver operating characteristic(ROC)curve was used to determine the diagnostic value and level threshold of NLR,MLR,PLR and SII in predicting type 2 diabetes with osteoporosis.Results:(1)The proportion of osteoporosis in women with type 2 diabetes(44.6%)was higher than that in men(23.1%),and the difference was statistically significant(x~2=10.098,P<0.01).(2)NLR,MLR,PLR and SII of type 2 diabetes mellitus with osteoporosis were significantly higher than those of type 2 diabetes mellitus with normal bone mass(P <0.05),there was no significant difference in other indicators between the two groups(P>0.05).(3)MLR in patients with osteoporosis were significantly lower than those in patients with type 2 diabetes mellitus and osteoporosis(P<0.05),there was no significant difference in other indicators between the two groups(P>0.05).(4)NLR,MLR,PLR and SII all had predictive value for type 2 diabetes with osteoporosis,with the corresponding maximum Youden index of 0.508,0.441,0.36 and0.36,respectively,and the corresponding cut-off value of 1.77 0.18 125.29 369.25,respectively.NLR had the highest Youden index,and its value was better than that of MLR,PLR and SII.(5)NLR,MLR,PLR and SII were all negatively correlated with BMD in patients with type 2 diabetes combined with osteoporosis,while NLR and SII were all positively correlated with β-CTX,while NLR and SII were not correlated with PINP.Conclusion:(1)The levels of NLR,MLR,PLR and SII in patients with type 2 diabetes mellitus complicated with osteoporosis were negatively correlated with the bone density of the lumbar vertebra,while NLR and SII were all positively correlated with β-CTX,while NLR and SII were not correlated with PINP.(2)The levels of NLR,MLR,PLR and SII in type 2 diabetes mellitus group were significantly higher than those in normal bone mass group.The MLR of type 2 diabetes mellitus with osteoporosis was significantly higher than that of osteoporosis alone.(3)Patients with type 2 diabetes with an NLR > 1.77 had an increased risk of osteoporosis,and the NLR had the highest Youden index and the best value. |
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