Correlation Between Serum Uric Acid And Bone Metabolism Indexes And Their TCM Syndrome Types In Middle-aged And Elderly Male Patients With Type 2 Diabetes Mellitus

Objective:The aim of this study was to investigate the relationship between blood uric acid(serum uric acid,SUA)and bone metabolic markers(Bone metabolic markers)and their Chinese medical evidence type in men with type 2 diabetes mellitus(T2DM)and to analyze their associated factors.Methods:1.Study population: 138 middle-aged and elderly male T2 DM patients hospitalized in the Department of Endocrine and Metabolic Diseases of Shandong Provincial Hospital from 2018 to 2020 were selected for inclusion in this study according to the exclusion criteria and inclusion criteria established in this study.2.Basic patient data were collected: detection of SUA,creatinine(Cr),alkaline phospatase(ALP),alanine aminotransferase(ALT),aspartate transaminase(AST),calcium(Ca),phosphorus(P),magnesium(Mg),Hemoglobin Alc(Hb Alc),parathyroid hormone(PTH),25-hydroxyvitamin D(25(OH)D),N-terminal Middle Molecular Fragment osteocalcin(N-MIDOC),Total Type I procollagen N-terminal propeptide(T terminal propeptide(T-PINP)and type I collagen crosslinking C-terminal Bate special sequence(B-CTX),and measured bone mineral density(BMD)of the right forearm of patients.The bone mineral density(BMD)of the patient’s right forearm was measured,as well as the information related to the Chinese medicine symptoms.3.Grouping: SUA trichotomous grouping was compared,and patients’ SUA levels were divided into U1 group(160.0-319.0 μmol/L),U2 group(320-399μmol/L),and U3 group(400-727 μmol/L)according to the trichotomous method.According to the TCM evidence,they were divided into liver and kidney deficiency evidence group,yin and yang two deficiency evidence group,and blood stasis pulse evidence group to explore the relationship between uric acid and bone metabolic markers and their TCM evidence in middle-aged and elderly male T2 DM patients,respectively.4.Data analysis: R4.1.2 software was used to process and analyze the data,and the measurement data conforming to normal distribution were expressed as mean ± standard deviation(?±s),and one-way ANOVA was used to compare between groups,and independent t-test was used for twoway comparison;for measurement data not conforming to normal distribution,kruskal-Waillis test was used to compare between groups,and Wilcoxon test was used for two-way comparison;for count data,kruskal-Waillis test was used for two-way comparison.Wilcoxon test;count data(which can also be categorical data)were expressed as frequencies and percentages,and the x2 test was used for comparison between groups.For correlation analysis,Pearson’s correlation(normal distribution)or Spearson’s correlation(non-normal distribution)was used.If P value >0.05,the difference was said to be statistically insignificant,if P <0.05,the difference was said to be statistically significant,and if P< 0.01,the difference was said to be statistically significant.Results:1.The blood uric acid levels of middle-aged and elderly male T2 DM patients showed no significant correlation with age,duration of disease,FPG,Hb A1 c,ALP,N-MIDOC,T-PINP,25(OH)D,Ca,Mg,and P;with the increase of SUA,BMI,PTH,Cr,and right forearm bone mineral density(T value)showed an increasing trend,and B-CTX and e GFR showed a decreasing trend and the difference was statistically significant(P<0.05);by Spearman correlation analysis,it was concluded that SUA was positively correlated with PTH and BMD(r>0)and was statistically significant(P<0.01).The correlation with B-CTX and e GFR was negative(r<0)and statistically significant(P<0.01)2.In the grouping of TCM evidence,liver and kidney deficiency evidence and blood stasis and vascular evidence were predominant,while those with phlegm-heat interconnection evidence were the least;there were no significant differences among the three groups in age,duration of disease,BMI,FPG,Hb A1 c,ALP,PTH,N-MIDOC,B-CTX,T-PINP,Ca,Mg,and P.The BMD value in the liver and kidney deficiency evidence group was the lowest,and the blood stasis and vascular evidence group had the25(OH)D were the lowest and the differences were statistically significant with the other two groups(P<0.05).Conclusion:1.Uric acid and right upper arm bone mineral density(T value)in middle-aged and elderly male T2 DM patients showed a significant positive correlation trend,indicating that high levels of uric acid have a positive effect on bone health,and in the treatment for patients with T2 DM combined with gout,uric acid levels should not be lowered,and maintaining high uric acid levels within the normal range appropriately is beneficial to reduce the occurrence of diabetic osteoporosis in patients.2.Using a combination of Chinese and Western medicine,if clinical symptoms related to liver and kidney deficiency and blood stasis obstruction are found in middle-aged and elderly male T2 DM patients,attention should be paid to timely dialectical treatment to control the development of the disease and prevent the disease from occurring.