The Association Between Bone Mineral Density And Serum Hormothyrin Level In Postmenopausal Women With Type 2 Diabetes

The first part The relationship between bone mineral density and serum hormothyrin level in postmenopausal women with type 2 diabetesObjective:To investigate the relationship between normal range of thyroid stimulating hormone(TSH) and hip bone mineral density in postmenopausal women with type 2 diabetes by bone mineral density test by comparing their general clinical data, biochemical index and bone mineral density.Methods:135 euthyroid postmenopausal females with type 2 diabetes were chosen from our endocrinology hospitalized patients from January 2013 to June 2015, and they were divided into 3 groups, according to their levels of serum TSH, namely, group A(0.27 m U/L~1.60 m U/L) which contained 40 cases, group B( 1.60 m U/L~2.90 m U/L) which contained 45 cases, group C(2.90 m U/L~4.20 m U/L)which contained 50 cases. Their general conditions, biochemical test index and bone mineral density were compared. The method of Pearson’s correlation analysis was used to test the correlation between BMD and other factors, and the method of multiple linear regression analysis was used to test the relationship between BMD and multivariate.Results:(1)The differences of duration of menopausal and BMI between group A and group C were statistically significant(P<0.05),so were the differences of duration of DM、Hb A1C、serum insulin、serum C peptide between group A and group B(P<0.05);(2)The differences of the level of TSH between any two groups had statistical significance(P<0.05);the level of FT3 of group A was significantly lower than that of group B(P<0.05);the level of HDL of group A was significantly higher than that of group B(P<0.05);(3)The left femoral neck,left femoral trochanter and total hip BMD were significantly lower than these of group B(P<0.05);while the differences of BMD between group A and group C、group B and group C were not(P>0.05);(4)There was no correlation between TSH and total hip BMD in euthyroid postmenopausal females with type 2 diabetes(r=0.078,P=0.594),so were the level of serum FT4、CHO、TG and total hip bone mineral density;while the age、duration of menopause、serum HDL were negatively associated with total hip BMD, respectively(r=-0.304,P=0.034;r=-0.314,P=0.029;r=-0.353,P=0.026);the BMI was positively associated with total hip BMD(r=0.310,P=0.026). After adjustment for age, duration of menopause, BMI and HDL, serum FT3 was still positively correlated with total hip BMD(r=0.401,P=0.006), while there was still no correlation between TSH,FT4 and total hip BMD(r=0.013,P=0.929;r=0.039,P=0.797).(5)In the multiple liner regression,FT3 was still associated with total hip BMD independently(B=0.114,P=0.006),so were the age(r=-0.011,P=0.035)and BMI(r=0.015,P=0.020),while the level of serum TSH、FT4 and HDL、duration of menopause were not。Conclusion:There was no correlation between the level of TSH and total hip BMD bone in postmenopausal women with type 2 diabetes who had normal thyroid function, even after adjustment for age, menopausal age, BMI, HDL, TSH. The second part: The correlation between subclinical hypothyroidism and BMD in postmenopausal women with type 2 diabetesObjective:To investigate the correlation between subclinical hypothyroidism and bone mineral density in postmenopausal women with type 2 diabetes.Methods:220 cases of postmenopausal women with type 2 diabetes were selected from January to June 2015 in Endocrinology Department of our hospital, 135 cases of normal thyroid function and 85 cases of subclinical hypothyroidism. Then the general conditions and biochemical indexes of the two groups were compared and the relationship between SCH and osteoporosis was analyzed. Pearson’s correlation analysis was used to analyze the correlation between BMD and other factors, the multivariate stepwise Logistic regression analysis was used to analyze risk factors of osteoporosis.Results:(1)The SBP、Hb A1C、FT3 of group D1 were significantly higher than those of group D2, while the level of TSH、TG、LDL、P were significantly lower than those of group D2, the BMD of neck of left femur、trochanter and left femur of group D1 were significantly higher than those of group D2,(P<0.05);(2)The levels of CHO、TG、serum phosphorus of group SCH were significantly higher than those of group NTF,while the level of FT4、BGP of group SCH were significantly lower than those of group NTF(P<0.05);(3)The left hip BMD of group SCH were significantly lower than that of normal thyroid function group(P<0.05);while there was no significant difference between group SCH and group NTF(P>0.05);(4)In the simple correlation analysis, TSH 、 CHO and serum phosphorus were positively correlated, respectively, and negatively correlated with FBG,BGP(P<0.05);(5)Osteoporosis and TSH were positively correlated in the postmenopausal women with type 2 diabetes,(OR=7.008,CI:1.333~36.834,P=0.021),and high level of TSH was an independent risk factor for osteoporosis after the adjustment of other risk factors.Conclusion:The level of TSH was negatively correlated with left hip BMD in postmenopausal women with type 2 diabetes who were suffering from subclinical hypothyroidism, and those patients were more likely to induce the decrease of bone mineral density even osteoporosis.