A Preliminary Study On The Influence Factor Of Bone Mineral Density And TCM Syndrome In T2DM Male Patients

Objective:In order to study the influence factors of bone mineral density and TCM syndrome in male T2DM patients,try to look for the new reference directions about the etiology of type 2 diabetes mellitus and osteoporosis arises,and try to provide objective index for TCM clinical basis.Method:Following the method of cross-sectional study,this study selected 260 cases of male inpatients with T2DM,who match the inclusion and do not meet exclusion standard,and are from the endocrinology department of Teaching hospital of Chengdu university of traditional Chinese medicine in the time from March 2016 to September 2016.Relevant clinical datas collected by history-taking and included Four Diagnostic Methods datas and BMD.Tthe 260 cases have divided into the normal bone mineral density group(DM),osteopenia group(DM-A),osteoporosis group(DM-B)according to BMD T value and 5 types group of The TCM syndromes.Results:1.Group analysis carried out by the T-value was divided into three groups:DM,DM-A and DM-B.(1)There were statistically significant differences between the three groups in age,disease course,BMI,TG,TC,2hPG,HbAlC,and drinking history(P<0.05),and the remaining few were not statistically significant.(2)Group DM-B,has the oldest age statistically significant compared with group DM and group DM-A(P<0.05).(3)Group DM-B has the biggest course compared with group DM and DM-A statistically significant(P<0.05).(4)In BMI,group DM-B had the smallest BMI and was statistically significant compared with group DM(P<0.05),that is,the lowest BMI is in the osteoporosis group.(5)In terms of blood lipid,there was no statistically significant difference between HDL-C and LDL-C.TG,TC in group DM-B,top of group DM and group DM-A has statistically significant difference(P<0.05).(6)In terms of blood glucose,there was A statistically significant difference between the three groups in the 2hPG group,and the group DM-B was higher than group DM and group DM-A,namely,the group of osteoporosis group was higher than normal bone density group and bone mass reduction group.(7)Between the three groups HbAlc,group DM was the lowest,group DM-A was the middle,group DM-B was the highest,were statistically significant(P<0.05),that is,the osteoporosis group had a higher bone mass than the other in HbAlc.(8)Osteopenia group and osteoporosis group had a high proportion of smoking.2.Whether is the normal bone mass as the dependent variable,age,BMI,course of diseases,smoking history,TG,TC,2hPG,HbAlC,DPN,diabetic retinopathy,NAFLD,diabetes,sexual dysfunction and other relevant factors as independent variables,logistic regression analysis is carried out:(1)Age,BMI,TG,TC,2hPG,HbAlC,DPN,NAFLD were the factors affecting the reduction of bone mass and osteoporosis in male with type 2 diabetes.(2)For male with type 2 diabetes,the risk of bone loss increased by 1.028 times for every 1 year of age.(3)For every 1kg/m~2 increase in BMI,the risk of bone loss increased by 0.893times.(4)The risk of bone loss increased by 1.097 times for every 1mmol/L of 2hPG;Every 1%increase in HbAlC increased the risk of bone loss by 1.148 times.(5)The risk of bone loss increased by 0.744 and 0.661 times for each 1mmol/L decrease in TG and TC.TC is an independent protective factor of bone mineral density in male T2DM patients.(6)Patients with NAFLD were 2.255 times more likely to have bone loss than those normal BMD.(7)The incidence of bone loss in patients without DPN was 0.289 times than that in patients with DPN.3.Group analysis carried out by TCM syndrome grouping.(1)Among the 260 study subjects,BMD in the normal range accounted for32.7%,osteopenia accounted for 48.1%,osteoporosis accounted for 19.2%.(2)TCM syndrome types:36 cases of Yin deficiency and excessive heat syndrome;44 cases of dampness,heat trapped spleen syndrome;97 cases of Qi-Yin deficiency syndrome;40 cases of syndrome of Yin-yang deficiency and blood stasis and water retention;and 43 cases of blood stasis syndrome.(3)There were significant differences in age,body weight,BMI and course of disease between the five TCM syndromes(P<0.01)and no significant difference in height(P>0.05).(4)The patients of syndrome of Yin-yang deficiency and blood stasis and water retention are older and have long course,whlie the Yin deficiency and excessive heat syndrome is opposite;The body weight and BMI of dampness,heat and spleen deficiency syndrome were the largest.(5)FN can reflect a certain degree of difference between the syndromes in the matter of BMC and aBMD.Conclusions:1.The bone mineral density is normal,osteopenia and osteoporosis in T2DM male patients.2.Age,BMI,TG,TC,2HPG,HbAlC,DPN,NAFLD are the primary influencing factors to reduce the bone mineral density in male T2DM patients,BMI,TG,TC are of protective factors,the rest is of the risk factors.3.TC is an independent protective factor of bone mineral density in male T2DM patients.4.The TCM syndromes of male T2DM were affected by age,weight,BMI and course of DM.5.FN can reflect a certain degree of difference between the TCM syndromes in the matter of BMC,aBMD in male patients with T2DM.The application of predicting the bone mass of T2DM male patients by TCMs was more valuable for FN,while the clinical value in the lumbar spine needs further evaluated.