Risk factors of osteoporosis in patients with type 2 diabetes

Li Honglei; Yang Tao; Fan Hongqi

doi:10.3760/cma.j.issn.1673-4777.2015.05.012

Abstract：Objective To explore the risk factors of osteoporosis (OP) in the patients with type 2 diabetes (T2DM).Methods Totally 187 patients with T2DM were enrolled and divided into normal bone mass group (58 cases,39 males,19 females),bone mass reduction group (103 cases,74 males,29 females) and OP group (26 cases,11 males,15 famles) according to the bone mineral density (BMD) detected by dual-emission X-ray absorptiometry.The history of smoking,drinking and exercise history,the age and the disease duration were recorded;the height,weight,fasting plasma glucose (FPG),2-hour postprandial plasma glucose (2 h PG),multi points insulin,glycosylated hemoglobin A1c (HbA1 c),triglyceride (TG),total cholesterol (TC),brachial-ankle pulse wave velocity (baPWV) and urinary albumin/creatinine ratio (ACR) were measured;the body mass index (BMI) and area under the curve of insulin (AUC-INS) were calculated.The correlations between BMD and main factors were analyzed.Results A higher proportion of OP was found in females compared with males [23.8％ (15/63) vs 8.9％ (11/124)] (P ＜0.01).The FPG and 2 h PG showed significant differences among the three groups in the males [(14.3 ± 2.6) mmol/L vs (15.0 ± 2.5) mmol/L vs (16.6 ± 2.3) mmol/L] (P ＜ 0.05 or 0.01),while showed no differences among the three groups in the females (all P ＞ 0.05).In OP group,the age,disease duration,FPG,2 h PG of the males were all significantly higher than those of the females [(73 ± 10) yearsvs (66±6) years,(13.7±3.8) years vs (12.6±3.7) years,(8.8±0.6) mmol/L vs (8.2±0.9) mmol/L,(16.6t2.3) mmol/L vs (14.2±1.7) mmol/L,(8.9±0.7)％ vs (8.2 ±0.8)％](P＜0.05 or 0.01),while the AUC-INS,TC and baPWV of the males were significantly lower than those of the females [(657 ± 148) min · pmol/L vs (714 ± 136) min · pmol/L,(5.2 ± 0.8) mmol/L vs (5.9 ± 0.8) mmol/L,(1 767 ± 227) cm/s vs (1 873 ± 165) cm/s] (P ＜ 0.05 or P ＜ 0.01).Correlation analysis revealed that BMD was negatively correlated with smoking,drinking,FPG and HbA1 c in the male patients (P ＜0.05 or 0.01),and was not correlated with FPG and HbAlc in the female patients (P ＞0.05);BMD was negatively correlated with age,disease duration,baPWV and ACR,positively correlated with exercise,AUC-INS and BMI (P ＜ O.05 or 0.01),not correlated with 2 h PG,TG and TC (P ＞ 0.05) in both the male and the female patients.Conclusions The BMD in patients with T2DM is affected by many factors,including exercise,age,disease duration,AUC-INS,BMI,baPWV,ACR in both male and female patents.Smoking,drinking,FPG and HbAlc is also correlated with BMD in male T2MD patients.