Efficacy Of Zoledronic Acid In Patients With Type 2 Diabetes Mellitus And Osteoporosis

Objective: To investigate the efficacy of zoledronic acid in patients withtype 2 diabetes mellitus(T2DM)and osteoporosis(OP),to explore whether the existence of T2 DM will affect the effect of zoledronic acid in the treatment of OP,and to evaluate whether the patients with T2 DM and OP are suitable for zoledronic acidtreatment.Methods: This study involves 228 osteoporosis patientswho treated with zoledronic acid in our hospital from January 2010 to April 2021,according to whether combined with type 2 diabetes,were divided into T2 DM combined with OP group and OP group.Among them 86 patients with T2 DM combined with OP and 142 OP patients were collected.The general data of age,sex,height and weight of 228 patients were collected,and level of serum lipids,blood calcium,blood phosphorus,alkaline phosphatase(ALP),Serumcreatinine,uric acid,femoral and lumbar bone mineral density(BMD)and pain score.Analyzed by spss25.0 software.The differences of biochemical indexes,bone density and pain scores before and after zoledronic acid were compared between the two groups,and the therapeutic effect of zoledronic acid was evaluated.Results: 1.Comparison between T2 DM combined with OP group and OP group.(1)Before zoledronic acid,the body mass index,triglyceride,blood calcium,alkaline phosphatase and uric acid of T2 DM patients with OP group were higher than those of OP group,the differences were statistically significant(P< 0.05).(2)After using zoledronic acid for one year,triglyceride and uric acid in T2 DM patients with OP group were higher than those in OP group,and the differences were statistically significant(P< 0.05).(3)Before using zoledronic acid,the lumbar spine L2,L3,L4 and BMD of T2 DM combined with OP group were higher than those of OP group,the differences were statistically significant(P< 0.05).There was no difference in BMD of lumbar L1,hip femoral neck,trochanter,internal,whole and ward’s.(4)After using zoledronic acid for one year,the lumbar L2,L3,L4 and BMD of T2 DM combined with OP group were significantly higher than those of OP group(P< 0.05).There was no significant difference in BMD of lumbar L1,hip femoral neck,trochanter,interior,whole and ward’s.(5)There was no significant difference in BMD between the two groups before and after zoledronic acid treatment.2.Comparison of all OP patients bone mineral density before and after zoledronic acid.(1)The bone mineral density of all OP patients before and after zoledronic acid treatment was compared,which indicated that the bone mineral density of L1,L2,L3,L4 and the whole lumbar vertebrae after zoledronic acid treatment for 1 year and 2years were higher than that before treatment,and the differences were statistically significant(P< 0.05).There was no significant difference in BMD of femoral neck,trochanter,internal,whole and ward’s.3.Comparison of zoledronic acid before and after treatment in T2 DM combined with OP group.(1)In T2 DM combined with OP group,the levels of serum calcium,phosphorus and alkaline phosphatase were significantly lower after 1 year of zoledronic acid treatment than before treatment(P< 0.05).(2)In T2 DM combined with OP group,the BMD of L1,L2,L3,L4 of lumbar vertebrae after 1 year and 2 years of zoledronic acid treatment was higher than that before treatment,and the differences were statistically significant(P< 0.05).There was no significant difference in BMD of femoral neck,trochanter,internal,whole and ward’s.4.Comparison of zoledronic acid before and after treatment in OP group.(1)In OP group,the blood phosphorus and alkaline phosphatase were lower than before treatment after one year of zoledronic acid(P< 0.05).(2)In OP group,L1,L2,L3,L4 and BMD of lumbar vertebrae were higher than that before treatment for1 year and 2 years after zoledronic acid(P< 0.05).There was no difference in bone mineral density of hip neck,internal,whole and ward’s.5.After stratified by age and creatinine clearance rate,the bone mineral density of patients in different groups was compared.(1)The results showed that the bone density of femoral neck,trochanter,internal,whole and ward’s in the group of < 65 years old was higher than that of ≥ 65 year old group,which was statistically significant(P< 0.05).There was no difference in bone mineral density of L1,L2,L3,L4 and the whole lumbar vertebrae between the two groups.(2)According to the median level of creatinine clearance rate,the patients were divided into groups with < 60 ml/min and ≥ 60 ml / min.compared with the two groups,whether before or after zoledronic acid of treatment,the bone density of the patients with creatinine clearance rate of < 60 ml / min group was lower than that of the group with femoral neck,trochanter,internal,whole and ward’s,which was lower than that of the group with creatinine clearance rate ≥ 60 ml/ min,and the difference was statistically significant(P< 0.05).There was no difference in bone mineral density of L1,L2,L3,L4 and whole lumbar spine.6.The pain score of all osteoporosis patients before and after zoledronic acid was compared.The pain score of T2 DM patients with OP group and OP group was lower than that before treatment(P< 0.05).Conclusion: 1.The BMD of lumbar vertebrae in T2 DM combined with OP group was higher than that in OP group.2.Zoledronic acid can increase the lumbar bone mineral density in patients with osteoporosis,and it can also increase the lumbar bone mineral density in patients with type 2 diabetes mellitus complicated with osteoporosis.3 Zoledronic acid has no significant effect on OP patients with T2 DM and OP patients without T2 DM.The presence of type 2 diabetes does not affect the anti osteoporosis effect of zoledronic acid.4 Zoledronic acid can reduce the pain of patients with osteoporosis.5 Age and creatinine clearance rate have a greater impact on hip BMD,but less impact on lumbar BMD.