Study On The Correlation Between Plasma Hcy And Related Risk Factores And Bone Mineral Density In Middle-aged And Elderly Patients With T2DM

Objective:To analyze the relationship between plasma Homocysteine(Hey)level and other related risk factors and bone mineral density(BMD)in patients with Type 2 diabetes mellitus(T2DM)in Yanbian area,and to provide theoretical basis for prevention and treatment of osteoporosis(OP)in T2DM patients.Research objects and methods:A total of 195 middle-aged and elderly T2DM patients hospitalized in endocrinology department of Yanbian hospital from April to December 2018 were randomly selected and their clinical data were retrospectively analyzed.According to the BMD values of the selected subjects,they were divided into 3 groups:normal bone mass group(99 cases),osteopenia group(61 cases)and osteoporosis group(35 cases).BMD values of subjects were measured by a dual-energy X-ray bone density detector.Age,sex,blood pressure,were recorded respectively.Plasma Hey level,glycosylated Hemoglobin Ale,HbAlc,creatinine(Cr),calcium(Ca),phosphorus(P),total cholesterol(TC),Triglyceride,TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),Body mass index,BMI),carotid intima-media thickness(IMT).SPSS22.0 was used for analysis.Results:1.Among 195 middle-aged and elderly T2DM patients enrolled in Yanbian area,35(18%)in osteoporosis group,61(31%)in osteopenia group and 99(51%)in normal bone mass group.The BMD level of women was lower than that of men.The BMD level of patients older than 60 years old was lower than that of patients younger than 50 years old,and the BMD level of patients olderthan 70 years old was lower than that of patients younger than 60 years old.With the increase of age,the proportion of normal bone mass decreased year by year,and the proportion of abnormal bone mass increased year by year.The BMD level of obese group was higher than that of normal BMI group.and the difference was statistically significant(P<0.05).With the increase of BMI,BMD level showed an upward trend,the proportion of normal bone mass increased,and the proportion of abnormal bone mass decreased.There was no significant difference in the course of disease and BMD level between Korean and Han nationality P>0.05).2.BMD level in carotid atherosclerotic plaque group was lower than that in normal carotid artery group(P<0.05).With the increase of carotid artery severity,BMD level decreased significantly and the proportion of OP increased.The probability of abnormal bone mass in carotid atherosclerotic plaque group was higher than that in non-carotid atherosclerotic plaque group(P<0.05).There was no statistical difference in the probability of abnormal bone mass between Korean patients with carotid atherosclerosis plaque and those without carotid atherosclerosis plaque(P>0.05).There was no statistical difference in the probability of abnormal bone mass between Han and Korean nationalities(P>0.05).arotid atherosclerotic plaque(OR=4.908)was a risk factor for OP.3.There was a negative correlation between plasma Hcy and BMD,and a positive correlation between BMI,DBP and BMD(P<0.05).There were no significant differences in SBP,HbAlc,Cr,CA,P,TC,TG,HDL-C and LDL-C among the three groups(P>0.05).There was no significant difference in the prevalence of OP between the Korean Hey normal group and the HHcy group(P>0.05).There was no significant difference in the prevalence of OP between Hey group and Hcy group(P>0.05).There was no statistical difference in the prevalence of OP between Han and Korean nationalities(P>0.05).Plasma Hcy(OR=1.109)was a risk factor for OP.Conclusion:1.BMD level is closely related to gender,age,BMI,DBP,plasma Hey and carotid atherosclerosis plaque in middle-aged and elderly patients with T2DM.2.The plasma Hcy level is negatively correlated with BMD level in middle-aged and elderly patients with T2DM,which is a risk factor for OP.3.Carotid atherosclerosis is a risk factor for OP in middle-aged and elderly patients with T2DM.