| Objectives DXA was used to analyze the changes of bone mineral density and structural parameters of lumbar vertebrae and hips in patients with T2DM with OP before and after combined anti-osteoporosis therapy,and to explore the effect of T2DM on the treatment effect of postmenopausal women with OP,so as to provide further reference for predicting the potential fracture risk of different parts of axial bone in postmenopausal women.Methods Patients diagnosed as OP in the osteoporosis clinic of the affiliated Hospital of North China University of Technology from September 2012 to September 2019 were selected.A total of 144 patients were included according to the inclusion and exclusion criteria.There were 72 postmenopausal women with OP with T2DM in OP+T2DM group and 72 postmenopausal women with OP without T2DM in OP group.The general conditions(age,weight,height,BMI,years of menopause,history of brittle fracture),values of BMD of lumbar vertebrae and hips,bone strength parameters of femoral neck and blood biochemical indexes of the two groups were recorded,and the consistency analysis of the basic data of the two groups was tested.Patients in both groups were treated with alendronate and calcitriol combined with calcium for 2 years,and the same parameters and adverse reactions in the course of treatment were evaluated and recorded in the first year and the second year,respectively.According to the group,the parameters of the two groups were compared.Results 1 Before treatment,there was no significant difference in age,weight,height,BMI,years of menopause,history of fragile fracture,BMD of each lumbar vertebrae and hip,and bone strength parameters of femoral neck(CAS,CSMI,Z,Cort,BR)between the two groups(P>0.05).2 In T2DM+OP group,the BMD values of lumbar vertebrae and hips increased 1 year after treatment,and the bone strength of femoral neck(CSA,CSMI,Z increased,BR decreased)increased significantly(P<0.05).After 2 years of treatment,the BMD of each lumbar vertebra and hip increased,and the bone strength of femoral neck(CSA,CSMI,Z,Cort increased,BR decreased),and the difference was statistically significant(P<0.05).3 In OP group,the BMD values of lumbar vertebrae and hips increased 1 year and 2 years after treatment,and the bone strength of femoral neck(CSA,CSMI,Z,Cort increased,BR decreased)increased,and the difference was statistically significant(P<0.05).4 After 2 years of treatment,the BMD growth rate of total lumbar vertebrae in the two groups was higher than that of femoral neck BMD,and the difference was statistically significant(P<0.05).5 After 2 years of treatment,the bone strength of femoral neck in T2DM+OP group(Z,Cort was lower,BR was higher)was lower than that in OP group,and the difference was statistically significant(P<0.05).6 After 2 years of treatment,the bone strength of femoral neck(Z,Cort)in T2DM+OP group increased more slowly than that in OP group,and the difference was statistically significant(P<0.05).7 After receiving alendronate,calcitriol combined with calcium,no serious adverse drug reactions occurred in the two groups,and the serum calcium,phosphorus and alkaline phosphatase in all patients were in the normal range during the treatment,which were(10.90±2.02)mg/dl,(3.64±0.73)mg/dl and(79±17)IU/L,respectively.There was no significant abnormality in liver and kidney function and blood and urine routine before and after treatment.Conclusions 1 Alendronate and calcitriol combined with calcium can effectively improve the bone mineral density and bone strength of OP patients with or without T2DM,and the improvement of bone mineral density of lumbar vertebrae is better than that of femur neck.2 T2DM delays the increase of bone strength of femoral neck in patients with OP after anti-osteoporosis combined therapy,but has no effect on the increase of bone mineral density,so the prevention of hip fracture in such patients should be strengthened.3 The bone strength structure parameters used in the evaluation of bone before and after treatment is a good supplement to the bone mineral density parameters.Figure 3;Table 9;Reference 149... |
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