| Objective:To investigate the correlation between peripheral blood cell analysis and osteoporosis(OP)in patients with type 2 diabetic mellitus(T2DM),To provide theoretical basis and clinical guidance for finding reliable,inexpensive and novel adjuvant predictors of T2 DM combined with OP.Methods:From January 2020 to January 2021,a total of 206 T2 MD patients who were admitted to the Department of Endocrinology in the First Hospital of Jilin University,were enrolled according to the inclusion and exclusion criteria,including 87 males and119 females.All patients enrolled were measured with dual-energy X-ray absorptiometry(DEXA)for lumbar spine and bilateral femur neck bone mineral density(BMD).According to the 1994 WHO diagnostic criteria for osteoporosis,bone mineral density status was divided into normal bone mass group(T≥-1),osteopenia group(-2.5<T<-1)and osteoporosis group(T≤-2.5)according to T level.Basic information such as age,sex,duration of diabetes,height,weight,history of hypertension,history of smoking,history of alcohol consumption,and BMI were recorded in the enrolled patients.Routine blood results were collected,and neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),and platelet to lymphocyte ratio(PLR)were calculated.Meanwhile,fasting blood glucose(FPG),glycosylated hemoglobin(Hb A1c),liver function,kidney function,lipids,ions,and thyroid function were collected.SPSS 25.0 software was used for statistical analysis.We compared the data of the three groups for any statistical differences,performed correlation analysis between clinical indicators and BMD,assessed the best critical value and predictive role of the relevant measures,and Logistic regression analysis was used to find the influencing factors of combined OP in T2 DM.Results:1.Age were statistically higher in the osteoporosis group than in the normal bone mass group and the osteopenia group(P<0.001),BMI was lower in the osteoporosis group than in the normal bone mass group(P<0.01).2.ALT was lower in the osteoporosis group than in the osteopenia group and the normal bone mass group,ALP was higher in the osteoporosis group than in the normal bone mass group,ALB was lower in the osteoporosis group than in the normal bone mass group,Cr and UA were significantly lower in the osteoporosis group and the osteopenia group,FT3 was lower in the osteoporosis group than in osteopenia group(P<0.01).3.RBC was significantly lower in the osteoporosis group than in the normal bone mass group(P<0.001),HB was significantly lower in the osteoporosis group than in the normal bone mass group and osteopenia group(P<0.001),PLT and PLR were higher in the osteoporosis group than in the normal bone mass group and osteopenia group(P<0.01).4.Pearson or Spearman correlation analysis showed that age,ALP,PLT were negatively correlated with L1-4 mean BMD and bilateral femoral neck mean BMD.PLR was negatively correlated with L1-4 mean BMD.RBC,HB,ALB,Cr,UA were positively correlated with L1-4 mean BMD and bilateral femoral neck mean BMD.BMI,ALT,TG were positively correlated with L1-4 mean BMD.5.The T2 DM combined with OP as the cut-off point and subject operating characteristic(ROC)curves were made.The results showed that the area under the ROC curve(AUC)for age,PLT,and PRL were 0.753,0.657,and 0.624,respectively,and the optimal screening cut-off values were 63.5,200,and 132.29,respectively,with sensitivities of 0.654,0.788 and 0.346,and the specificity was 0.753,0.500 and 0.922,respectively.Age,PLT,and PLR were considered to be predictive of the development of OP in patients with T2 DM,but the sensitivity and specificity of age and PLT were not high,and the sensitivity of PLR was not high.6.The study population was divided into osteoporosis group(T value≤-2.5)and non-osteoporosis group(T value >-2.5)according to BMD,the results of multi-factor logistic regression analysis with combined OP as the dependent variable and related variables were found: age >63.5 years,PLT >200 10^9/L,and PLR >132.29 were risk factors for T2 DM combined with OP,the lower the BMI,RBC and higher the ALP,the higher the risk of T2 DM combined with OP.Conclusions:1.Age and PLT were negatively correlated with L1-4 mean BMD and bilateral femoral neck mean BMD.PLR was negatively correlated with L1-4 mean BMD.BMI was positively correlated with L1-4 mean BMD.RBC and HB were positively correlated with L1-4 mean BMD and bilateral femoral neck mean BMD in patients with T2 DM.2.The smaller the BMI and the lower the RBC the higher the risk of combined OP in patients with T2 DM.Age >63.5 years,PLT >200 10^9/L,and PLR >132.29 were risk factors for T2 DM combined with OP.3.Age,PLT,and PLR are all predictive of combined OP in T2 DM,but further studies are needed. |
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