The Analysis Of Bone Mineral Density And Parameters Of Bone Metabolism In Patients With Type 2 Diabetes

Objective:Analysis of bone mineral density in patients with type 2 diabetes and changes of parameters of bone metabolism. Detection of type 2 diabetic patients with non-diabetic patients with bone mineral density and parameters of bone metabolism differences, to describe the relationship between type 2 diabetes and osteoporosis. Observe bone mineral density and the changes of parameters of bone metabolism in patients with type 2 diabetes with different course of the disease, age and gender. Analysis the factors of bone mineral density and bone metabolism in patients with type 2 diabetes.Methods:This study selected from April 2010 to August 2010 Endocrinology, hospitalized in our hospital 71 patients with T2DM patients,14 cases of non-diabetic control group. According to duration, type 2 diabetic patients were divided into groupⅠ(duration 0-5 years) of 24 cases, groupⅡ(duration 6-10 years) of 23 cases, groupⅢ(disease duration> 10 years) of 24 cases. Divided by sex, male group of 36 cases, female guoup 35 cases. Blood calcium, blood phosphorus,24-hour urinary calcium,24-hour urinary phosphorus were measured. Dual energy X ray absorptiometry (DXA) measured lumbar 2 to lumbar spinal 4 (L2-L4), femoral neck (Neck) and total body BMD. Serum PINP,β-crosslaps,sRANKL and OPG were measured in all of the patients. All data analyzed by SPSS 18.0 statistical package. Used for statistical t test, single factor variance analysis and multiple regression analysis. P<0.05 (bilateral) is set to have statistically significant.Results:1. DM group and non-DM groups, osteoporosis and bone loss were significantly increased. Between the two groups, ages, BMI, serum Ca, serum P, serum ALP, urinary Ca and urinary P had no significant difference. L2-L4 and whole body BMD of DM group were significantly lower than non-DM group, the difference was statistically significant. Between DM group and non-DM group, PINP,β-crosslaps, sRANKL had no significant difference. OPG level of DM group was significantly higher than non-DM group, the difference was statistically significant.2. Male DM group and female DM group:The male subgroup of DM compared with the female subgroup, the L2-L4 and total body BMD of female were significantly lower than males, the difference was statistically significant. Serum of PINP,β-Crosslaps in female were higher than males, the difference was statistically significant. No significant difference between OPG and sRANKL between male and female group.3. DM patients grouped by duration of disease:Ⅲgroup compared with non-diabetic group, the BMD at L2-L4 lumbar vertebrae, at the femur (neck) and total body BMD were significantly lower. The total body BMD ofⅡgroup was significantly lower than that in the non-diabetic group.Ⅲgroup campared withⅠgroup, the whole body BMD was significantly reduced. Serum PINP andβ-Crosslaps in each group showed no significant difference.Ⅰgroup,Ⅱgroup of serum OPG were significantly higher than non-diabetic group, the difference was statistically significant.Conclusions:1. The patients with type 2 diabetes had increased risk of bone loss and osteoporosis.2. Bone mineral density in patients with type 2 diabetes lower than the control group and decreased gradually with prolonged duration of disease. The bone mineral density of the female DM patients was significantly reduced than male. 3. Indicators of bone formation PINP and bone resorption indicesβ-crosslaps, had no significant difference in type 2 diabetes and non-diabetic control group and between different courses. In postmenopausal women with type 2 diabetes patients, both of them were significantly increased.4. Bone protection element OPG in type 2 diabetic patients significantly increased than the controls. However, in postmenopausal women than men of same age, OPG did not show significant differences. sRANKL in diabetic compared with non-diabetic patients had no significant difference.