Study On The Correlation Between Body Composition Changes And Bone Loss In Patients With Type 2 Diabetes

Objective: The purpose of this study was to to analyze the correlation between body composition and bone mineral density(BMD)in type 2 diabetic patients.Methods: This is a follow-up study,which included a total of 544 type 2 diabetes patients(274 males and 270 females)with a median follow-up time of 2.33 years.We divided the subjects into body mass index(BMI)increasing group,BMI stable group and BMI decreasing group.And we obtained the correlation between the changes of body mass index(BMI),the whole body fat mass index(FMI),the whole body muscle mass index(MMI),the ratio of the whole body muscle mass to the whole body fat mass(M/F),the trunk fat mass index(TFMI),the appendicular skeletal muscle mass index(ASMI),the ratio of the appendicular skeletal muscle mass to the trunk fat mass(A/T)and the changes of lumbar and femoral neck BMD(LBMD and FNBMD)by linear regression analysis and logistic regression analysis.By recording the working curve of the subjects,we obtained the best threshold of the annual change rate of M/F and A/T,which keeps the femoral neck bone mineral density stable or increasing.Results: As the age and course of the disease prolonged,M/F,A/T,and FNBMD in T2 DM patients decreased,but BMI,other body composition indexes,and LBMD did not change significantly.The changes of FMI and TFMI are negatively correlated with the changes of FNBMD(β=-0.040;95%CI-0.049～-0.031;P<0.05;β=-0.042;95%CI-0.055～-0.029;P<0.05),and the changes of MMI,ASMI,M/F,A/T are positively correlated with the changes of FNBMD(β=0.034;95%CI 0.024～0.044;P<0.05;β=0.032;95%CI 0.010～0.053;P<0.05;β=0.019;95%CI 0.011～0.027;P<0.05;β=0.009;95%CI 0.002～0.017;P<0.05).The risk of FNBMD reduction in patients in the M/F stable group and the increased group was 79.7% and 83.8% lower than that of the patients in the M/F reduced group,respectively.The risk of FNBMD reduction in patients in the A/T stable group and the increased group was 66.6% and 72.0% lower than those in the A/T reduced group,respectively.The annual change rate of M/F is not less than 0.00%/year,and the annual change rate of A/T is not less than-0.50%/year,which can keep FNBMD stable.Conclusion:Although age or the course of diabetes are important risk factors for bone loss in diabetic patients,a reasonable muscle/fat ratio is still beneficial to the maintenance of bone mass.