Association between left ventricular remodeling and diastolic dysfunction with bone mineral density in elderly patients with T2DM

LIU Yu-rong; JIANG Jian-xiang; DU Pei-yan; ZHANG Tong-qian; LYU Hai-hong

doi:10.19538/j.nk2025080108

Abstract：Objective To investigate the association of left ventricular remodeling(LVR)and left ventricular diastolic dysfunction(LVDD)with bone mineral density(BMD)and fracture in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 361 elderly T2DM patients admitted to the First Hospital of Lanzhou University from January 2021 to January 2024 were included,and another 61 non-diabetic elderly patients during the same period were selected as the control group.The T2DM patients were divided into three groups based on BMD levels:normal group,osteopenia group,and osteoporosis group.Their fracture history and blood and urine biochemistry were collected,left ventricular remodeling was assessed using body surface area-standardized left ventricular mass index(LVMI)and relative ventricular wall thickness(RWT),and left ventricular diastolic function was assessed by E/A and mean e.BMD was measured using dual-energy X-ray absorptiometry(DXA),and the Fracture Risk Assessment Tool(FRAX)was adjusted to assess the risk of osteoporotic fracture at the hip(HF)and major site(MOF)over the next 10 years;statistical analyses were performed using SPSS 27.0 software.Results Compared with non-diabetic patients,T2DM patients had higher levels of FPG,LAD,IVST,LVMI and incidence of LVDD,lower BMD of lumbar spine(LS),femoral neck(FN)and whole body(WB),and significantly increased incidence of MOF,HF and fragility fractures(P＜0.05).In T2DM patients with different BMD levels,fracture risk increased significantly as BMD levels decreased and LVMI levels and the prevalence of LVDD increased.Correlation analysis showed that LVMI and LVDD were significantly correlated with decrease of BMD and increase of fracture risk(P＜0.05),but not with fragility fracture.Multifactorial linear regression analyses showed that LVMI and LVDD were negatively correlated with BMD of FN,WB and LS,while positively correlated with fracture risk.After adjusting for confounders,LVMI remained significantly correlated with low BMD and high fracture risk,while LVDD was not correlated with them.Conclusion LVR and LVDD are associated with decreased BMD and increased fracture risk in elderly T2DM patients,and LVMI is independently associated with them,which suggests that abnormal heart structure and function may be related to the risk of osteoporosis.