Analysis Of Bone Mineral Density In Postmenopausal Female With Impaired Glucose Tolerance And Clinical Significance

[Objective]Based on the precision of the measurements of body composition and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), we analyzed changes of BMD in postmenopausal female patients with essential hypertension who is suffering impaied glucose tolerance on the purpose of investigating the effect of IGT on postmenopausal female patients, and exploring the possible mechanism.107 postmenopausal female patients from section of cardiology and endocrine and outpatient section of the first affiliated hospital of Jinan university were selected and recorded the basic file, then accepted blood test. They were divided into 55 cases of normal control group,28 cases of pure IGT group,24 cases of IGT combined EH group according to the IGT and hypertension diagnostic criteria. BMD of total body,partial lumbar spine (lumbar vertebrae L1-L4) and proximal femur (including the femoral neck, trochanter and Ward's triangle) were determined by DXA. All data had been analyzed by SPSS 13.0. Prevalence of osteoporosis were compared between the IGT two groups using Chi-square test, and BMD was compared using covariance analysis. Among the three groups, BMD and laboratory indicators were compared by independent samples T test respectively. The correlation between BMD and risk factors was analyzed using multiple regression method and linear correlation analysis.[Results]In the IGT two groups, The prevalence of lumber osteoporosis in hypertension group were higher than that of the non-hypertension group (P<0.05) while there was no significant difference between the two groups in the whole body OP, bilateral proximal femoral component ratio of OP (P>0.05). All BMDs in the hypertension group were higher than that in the non-hypertension group, and there were significant differences in lumbar L1,L2,L3,L4 BMDs between the two groups (P values were 0.021,0.033,0.036 and 0.029 respectively); however, the difference disappeared after adjustment for the BMI and postprandial 2h C-peptide, the P value also increased remarkably. The level of systolic blood pressure (SBP),diastolic blood pressure (DBP),the postprandial 2h plasma glucose, HbAlc and C-peptide in IGT group were significant higher than that in normal control group while there was no significant difference between the two groups in the level of TC, TG, HDL-C, LDL-C and other indicators. BMDs in lumbar L2,L3,L4 and Ward's triangle in IGT group were significantly lower than that in the normal control group (P values were 0.031,0.026,0.034 and 0.039 respectively), while there was no significant difference between the two groups in BMDs in total body,lumbar spine L1,femoral neck and greater trochanter (P values were 0.329,0.374,0.085 and 0.432 respectively) Multiple regression method and linear correlation analysis showed that BMDs were associated with menopause age,OGTT postprandial 2h plasma glucose,body mass index (BMI) and hypertension combined with IGT.[Conclusion]BMDs in some lumbar spine and Ward's triangle were significantly reduced in postmenopausal female patients. BMDs in lumbar spine were notably lower in postmenopausal female patients with IGT than those without IGT; while there is no significant differences in Ward's triangle BMDs. BMDs were negatively correlated with postmenopausal age,postprandial plasma glucose and mean arterial pressure but positively with BMI.