| BACKGROUNDThe incidence of type 2 diabetes mellitus(T2DM)is increasing year by year.The aging of population in China is accelerating,and the study of T2 DM patients with osteoporosis has been paid more attention in clinical.However,the correlations between them are not clear,and their pathogenesis is not clarified.OBJECTIVEThe purpose of this study is to explore the potential risk factors of osteoporosis in patients with T2 D by studying the population characteristics and risk factors of patients with T2 DM.METHODS1.The study population consisted of 2985 T2 DM patients who were admitted to the Department of Endocrinology in Shenzhen Second People’s Hospital from January1,2017 to December 31,2020 and diagnosed according to the latest guidelines.After screening according to the standard of inclusion and exclusion,and collecting medical records according to the data form of DOP-B2F3M2 database,618 patients with complete data were finally obtained.The population was divided into the combined osteoporosis group and the non-osteoporosis group with 359 and 259 cases respectively.And analyzed by stratified subgroup with age,Hb A1 c,duration and gender.2.The characteristics of the osteoporosis group and the non-osteoporosis group were compared.The differences between the two groups were analyzed.Continuous measurement data were presented as mean ± SD.Comparison between groups was performed by Wilcoxon rank sum test(between two groups)or Kruskal Wallis rank sum test.Chi-square test was used to compare the enumber data,and the classification variables were represented by the number of cases and percentage.The influencing factors of uric acid on osteoporosis were analyzed by non-conditional logistic stepwise regression.The effects of other factors on osteoporosis in T2 DM patients were analyzed by stratified subgroup,and the analysis results were cross-examined.RESULTS1.Compared with the non-osteoporosis group,osteoporosis group has most likely population of women,older,lower BMI,and less alcohol drinking.Hb A1 c,fasting blood glucose,BTM were higher,25 hydroxyl vitamin D3 and serum uric acid were lower in osteoporosis group.2.Both univariate(OR 0.82 95%CI 0.74,0.90 P<0.0001)and multivariate(OR0.83 95%CI 0.70,0.97 P=0.0227)analyses suggested that uric acid had a significant and stable effect on osteoporosis,and the two were negatively correlated.In addition,the effect of 25 hydroxyvitamin D3 on osteoporosis was also significantly stable(P<0.05).3.Stratified analysis and cross-test showed that uric acid concentration was negatively correlated with osteoporosis,which was a protective factor(OR<1),and the correlation was stable under all influencing factors(P>0.05).However,the correlation was significantly different with gender(P=0.0125).4.Logistic regression analysis in this study indicated that the higher the uric acid concentration,the lower the risk of osteoporosis(OR=0.82 95%CI 0.74-0.90P<0.0001).After adjusting for other factors,the correlation was stable and significant(OR=0.83 95%CI 0.72-0.96 P=0.0109).In men with type 2 diabetes,the risk of osteoporosis decreased by 25% for each 1mg/dl increase in uric acid(OR=0.7595%CI 0.61-0.91 P=0.0042).CONCLUSIONIn patients with type 2 diabetes,blood uric acid levels were inversely associated with osteoporosis,and the risk of osteoporosis was statistically reduced by 18% for approximately 1mg/dl increase in uric acid levels,independent of other factors,and by 17% after adjustment,according to statistical analysis.The degree of correlation was different in different sex subgroups.The association was significant for men,but not for women.In men with type 2 diabetes,each 1mg/dl increase in uric acid concentration was associated with a 25% reduction in the risk of osteoporosis.Uric acid is a protective factor of osteoporosis,and normal or elevated uric acid can reduce the risk of osteoporosis in patients with type 2diabetes. |
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