Analysis Of The Correlation And Influencing Factors Between Carotid Atherosclerosis And Bone Mineral Density In Postmenopausal Patients With Type 2 Diabetes Mellitus

Objective:Our study aims to investigate the correlation and the influencing factors between carotid atherosclerosis and bone mineral density in postmenopausal patients with type 2 diabetes mellitus.We intend to provide scientific basis for the prevention of atherosclerosis and osteoporosis in postmenopausal patients with type 2 diabetes mellitus.Methods:This is a retrospective study.155 postmenopausal diabetic patients were drawn in the First Hospital of He Bei Medical University from April 2019 to September 2020.All the patients were content with the inclusion and exclusion criteria which according to the specific requirements of our article.The general clinical data,biochemical parameters,the data of carotid Color Doppler ultrasound examination and bone mineral density were collected.According to the plaque formation,research objects were divided into control group(n=50)and plaque group(n=105),according to the bone mineral density of lumbar spine and hip in plaque group,they were divided into normal bone mass group(n=29),osteopenia group(n=45)and osteoporosis group(n=31).Logistic analysis was used to analyze the influencing factors of carotid atherosclerotic plaque,and Pearson correlation analysis was used to analyze the influencing factors of hip and lumbar bone mineral density.Finally,we discussed the relationship and the influencing factors between carotid atherosclerosis and bone mineral density.Results:1.In the comparison of baseline data,Plaque group were with advance age,longer duration of menopause,and lower bone mineral density,most of them were treated with insulin.There were significant differences in the age,duration of menopause,history of insulin treatment,hip bone mineral density,hip T-score,lumbar bone mineral density,lumbar T-score between plaque group and control group,Their P values were 0.001,0.045,0.017,0.011,0.001,0.028 and 0.037 respectively.Meanwhile,osteoporosis group were with advance age,longer duration of menopause and larger plaque.There were significant differences in age,duration of menopause,mean carotid plaque thickness,mean carotid plaque length,alkaline phosphatase,triglyceride between different bone mass groups,Their P values were 0.000,0.000,0.006,0.000,0.038 and 0.044 respectively.2.In the binary logistic regression analysis,age(OR=1.109,P=0.023),history of insulin treatment(OR=2.841,P=0.024),hip bone mineral density(OR=0.033,P=0.028),hip T score(OR=0.520,P=0.002),lumbar bone mineral density(OR=0.034,P=0.020),lumbar T score(OR= 0.700,P=0.026)were independent risk factors for carotid atherosclerotic plaque formation.The study showed that the incidence of carotid plaque increased in patients who were possessed of advanced age,lower bone mineral density,and history of insulin treatment(the degree of pancreatic injury).3.In the Pearson linear correlation analysis,It found that hip and lumbar bone mineral density were positively correlated with body mass index and negatively correlated with age,duration of menopause,duration of disease,mean carotid plaque thickness and mean carotid plaque length.Conclusions:1.Carotid atherosclerosis was closely related to bone mineral density in postmenopausal patients with type 2 diabetes mellitus.2.In postmenopausal patients with type 2 diabetes mellitus,low bone mineral density was an independent risk factor for the incidence of carotid plaque,and they are negatively correlated between the reduction of bone mineral density and the size of carotid atherosclerotic plaque.3.Age,menopause years,islet β-cell function,blood glucose and blood lipid are the common influencing factors of atherosclerosis and bone mineral density.