| Objective To explore the correlation between serum uric acid and bone mineral density,fragility fractures and bone metabolism indexes in middle-aged and elderly patients with type2 diabetes,and to explore whether serum uric acid has predictive value for osteoporosis and risk factors for fragility fractures.Methods Statistics of patients with type 2 diabetes who were hospitalized in the Endocrinology Department of the First Clinical Medical College of Three Gorges University(Yichang Central People’s Hospital)from January 2016 to December 2018,requires that all patients were treated with oral hypoglycemic drugs or insulin injections,Postmenopausal women aged ≥45 years old and at least 1 year without menstruation,or male patients ≥60years old,a total of 370 study subjects were included according to the inclusion and exclusion criteria,a total of 370 cases of the research object,among which 138 were male,female 232 cases,Collect basic patient data and research indicators: Bone density(BMD),uricacid(UA),fastingbloodglucose(FPG),glycosylatedhemoglobin(HBALC%),special series ofβ-caroxylterminalpeptide(β-CTX),25--hydroxyitamin D(25 hydroxyvitamind,25(OH)VD),osteocalcin(osteocalcin,OC),a series of blood lipid,renal function index,diabetes complications such as index,According to the blood uric acid level of patients,they were divided into 3 groups(U1 group SUA<360 umol/L),U2 group 360≤SUA<420umol/L,U3 group SUA≧420umol/L):(1)to investigate the different research object uric acid between groups of baseline data;(2)The correlation between serum uric acid and bone mineral density and bone metabolism in each group was analyzed by multiple stepwise linear regression.(3)To explore whether blood uric acid has predictive value for osteoporosis.(4)Explore the independent risk factors of fragility fractures in diabetic patients;Results :(1)SUA and Hb A1 c % in males were higher than those in females(all P < 0.05),BMD,OC,TG and TC were lower than those in females(all P < 0.05).(2)There were statistically significant differences in the duration,BMD,SUA,25(OH)D,TG and HDL of diabetes among the three male groups(P < 0.05).BMD and 25(OH)D in U2 group were higher than those in U1 group,and the duration,CR,TG and HDL of diabetes in U3 group were higher than those in U1 group(all P < 0.05).(3)There were statistically significant differences in the course,age,BMD,SUA,FPG,Hb A1 c %,CCR,Cr and ACR of diabetes among the three female groups(P<0.05).The duration of diabetes and Cr in U3 group were higher than those in U1 group,and Ccr was lower than U1 group,the difference was statistically significant(P<0.05).(4)Male U1,U3 group SUA and BMD are negatively correlated,U2 group SUA is positively correlated with BMD(P<0.05),and there is no significant correlation with various bone metabolism indexes.After adjusting for related confounding factors,SUA and BMD in U2 group are still It is positively correlated.(5)SUA and BMD in U1 and U2 groups were positively correlated(P<0.05),while SUA and BMD in U3 group were negatively correlated(P<0.05).After adjusting for related confounding factors,SUA and BMD in U1 and U2 groups were still positive Related..(6)SUA has a predictive value for osteoporosis,and the optimal cut-off value is332.3umol/L for males and 327.55umol/L for females.(7)Age,SUA,Hb A1 c %,FPG,DN and CHD were independent risk factors of brittle fracture in female group;(8)SUA,Hb A1 c % and CHD were independent risk factors of brittle fracture in male group;Conclusion :(1)Duration of diabetes,age and creatinine are risk factors for hyperuricemia.(2)In both men and women,lumbar bone density was the highest in normal high uric acid level,and the two were positively correlated.(3)Serum uric acid has a predictive value in the diagnosis of osteoporosis,and a slightly higher level of normal uric acid has a protective effect on osteoporosis.(4)Age,blood uric acid,glycosylated hemoglobin,fasting blood sugar,diabetic kidney disease,coronary atherosclerosis,heart disease is a independent risk factor for brittle fracture in patients with type 2 diabetes,in which women blood uric acid for every rise in unit brittle fracture risk by 0.7%,male blood uric acid for every rise in unit brittle fracture risk by 0.4%. |
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