| Objective:To investigate the relationship between bone mineral density(BMD) and sex hormone and PTH in elderly male patients with type 2 diabetes mellitu(T2DM)through comparing the difference of sex hormone and PTH at the vary BMD status.Methods: 1.We collected 151 elderly male patients with T2 DM in our hospital from January 2014 to December 2015, aged 60-95 years.The BMD of lumber vertebral(L1 to L4), femoral neck(FN) and total hip(TH) in all patients were measured by dual energy X-ray absorptiometry, and the subjects were divided into normal bone mass group and bone mass reduction and osteoporosis according to BMD.2.The age,height,weight,waist, hip, blood pressure and course of diabetes were measured and recorded,then calculate the body mass index(BMI) and waist hip radio(WHR).Fasting blood glucose(FPG), postprandial blood glucose(PBG),lipids,calcium and phosphorus were detected by automatic chemistry analyzer. The level of glycosylated hemoglobin(Hb A1c) was measured by high pressure liquid chromatography(HPLC).The level of sex hormones and PTH were measured by chemiluminescent method.3. Statistical analysis of data.Results: 1.Comparison of clinical data between the three groups:47 cases of normal bone mass(31%),81 cases of osteopenia(54%),23 cases of osteopenia(15%).There were no statistical differences in age、SBP、DBP and WHR among the three groups.The data can be compared. The course of diabetes and BMI were statistically different among the three groups(P<0.01). The results of further paired-comparisons showed the course of diabetes of the osteoporosis group were longer than that of the normal bone mass group and the osteopenia group(8.78±5.36,5.70±3.20,7.08±2.61,P<0.05), and BMI of the normal bone mass group were higher than that of osteopenia group and osteoporosis group(25.81±2.90,24.54±2.69,23.39±3.56,P<0.05).2.Comparison of biochemical indicator between the three groups:the level of HDL-C of the osteoporosis group were higher than that of the normal bone mass group and the osteopenia group(1.32±0.38,1.11±0.28,1.31±0.29,P<0.05),and there were no statistical differences between the osteopenia group and the normal bone mass group.There were no statistical differences in FPG、PBG、Hb Alc、TC、TG、LDL-C、Ca、P and PTH among the three groups(P>0.05).3.Comparison of sex hormone between the three groups:the levels of T of the osteoporosis group were lower than that of the normal bone mass group and the osteopenia group(11.49±6.81,15.08±6.60,17.86±6.00,P<0.05),and the levels of T of the osteopenia group were lower than that of the normal bone mass group. The levels of E2 of the osteoporosis group were lower than that of the normal bone mass group and the osteopenia;There were no statistical differences in FSH、LH and PRL and PTH among the three groups(P>0.05).4.Pearson correlation analysis revealed that the levels of T and BMI were positively correlated with the BMD of L1 to L4, FN and TH(r=0.321,r=0.243,r=0.235;r=0.193,r=0.264,r=0.213 P<0.05);E2 was positively correlated with the BMD in FN(r=0.251, P<0.05);HDL-C was negatively correlated with BMD of L1 to L4, FN and TH(r=-0.247,r=-0.175,r=-0.183,P<0.05);The course of diabetes was negatively correlated with BMD in L1 to L4(r=-0.194,P<0.05);No associations were abserved between BMD and age、FPG、PBG、Hb Alc、TC、TG、LDL-C、Ca、P and PTH.5.In the multiple linear regression analysis,the BMD as dependent variables,the levels of age、BMI、WHR、SBP、DBP、FPG、2h PG、Hb A1c、TC、TG、LDL-C、HDL-C、Ca、P、T、E2 、PTH and other indicators as independent variables,the results displayed BMI、TC、T and HDL-C went into the regression equation.The regression equation is y=1.806+0.012(BMI)+0.019(TC)+0.004(T)-0.001(HDL-C)。Conclusion: 1.The majority of elderly male patients with T2 DM will appear bone loss or osteoporosis,the longer the duration of diabetes more influence on BMD.2.E2,T,HDL-C and BMI are correlated with BMD in elderly male patients with T2 DM, involved in occurrence and development of diabetic osteoporosis. |
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