|
|
Analysis of osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus |
XU Ping1, XU Min2, QIN Yan2, SHI Liang3, YUAN Guo-yue1, YANG Ling1 |
(1. Department of Endocrinology, 2. Department of Gastroenterology, 3. Department of Nuclear Medicine, the Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China) |
|
|
Abstract [Abstract]Objective: To study the osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus. Methods: A total of 154 elderly male patients with type 2 diabetes were divided into three groups: normal group, osteopenia group and osteoporosis group.Bone mineral density(BMD) were measured by dual-energy X-ray absorptiometry(DXA). BMI, HbA1c, FBG, PBG, fasting C peptide, postprandial C peptide, serum calcium (Ca2+), TG, TC, LDL-C,HDL-C,serum uric acid and hs-CRP were measured. Results: The age and duration of diabetes in osteopenia group and osteoporosis group were significantly higher than those of normal group(P<0.05), while BMI in osteopenia group and osteoporosis group was significantly lower than that of normal group(P<0.01). HbA1c and hsCRP significantly increased in osteopenia group and osteoporosis group compared with normal group, while fasting C peptide, postprandial C peptide significantly decreased. There was no significant difference in FBG, PBG, serum calcium (Ca2+), TC, TG, HDLC, LDLC, and serum uric acid among the three groups(P>0.05). Conclusion: The BMD of elderly male type 2 diabetes patients may be correlated with the age, duration of diabetes and BMI. Bigger BMI may be a protective factor, while poor insulin function and poor control of blood glucose may be risk factors. In addition, inflammatory factor hsCRP may play roles in the pathogenesis of osteoporosis in elderly male type 2 diabetes patients.
|
Received: 20 October 2015
|
|
|
|
\[1\]Liu EY,Wactawski WJ,Donahue RP, et al. Does low bone mineral density start in postteenage years in women with type 1 diabetes?[J]. Diabetes Care, 2003, 26(8): 2365-2369.\[2\]Dennison EM,Syddall HE,Aihie Sayer A,et al. Type 2 diabetes mellitus is associated with increased axial bone density in men and women from the Hertfordshire Cohort Study: evidence for an indirect effect of insulin resistance[J]. Diabetologia,2004,47(11):1963-1968.\[3\]Schwartz AV,Sellmeyer DE,Strotmeyer ES,et al. Diabetes and bone loss at the hip in older black and white adults[J]. J Bone Miner Res, 2005, 20(4): 596-603.\[4\]Nakamura K, Saito T, Kobayashi R, et al. Creactive protein predicts incident fracture in communitydwelling elderly Japanese women: the Muramatsu study[J]. Osteoporos Int,2011,22(7):2145-2150.\[5\]Moerman EJ, Teng K, Lipschitz DA, et al. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: the role of PPARγ2 transcription factor and TGFβ/BMP signaling pathways[J]. Aging Cell,2004,3(6):379-389.\[6\]Coe LM, Irwin R, Lippner D, et al. The bone marrow microenvironment contributes to type Ⅰ diabetes induced osteoblast death[J]. J Cell Physiol, 2011,226(2):477-483.\[7\]Ivers R, Cumming R, Mitchell P, et al. Diabetes and risk of fracture\[J\]. Diabetes Care, 2001,24(7):1198-1203.\[8\]Paul R, Bailey A. Glycation of collagen: the basis of its central role in the late complications of ageing and diabetes\[J\]. Int J Biochem Cell Biol, 1996,28(12):1297-1310.\[9\]张秀珍,王博,丁晓晨,等.绝经后女性2 型糖尿病患者骨转换生化指标的研究\[J\].中华骨质疏松和骨矿盐疾病杂志,2012, 5(1):30-34.\[10\]Yamagishi S, Nakamura K, Inoue H. Possible participation of advanced glycation end products in the pathogenesis of osteoporosis in diabetic patients\[J\]. Med Hypotheses, 2005,65(6):1013-1015.\[11\]Alikhani M, Alikhani Z, Boyd C, et al. Advanced glycation end products stimulate osteoblast apoptosis via the MAP kinase and cytosolic apoptotic pathways\[J\]. Bone, 2007,40(2):345-353.\[12\]Fulzele K,Riddle RC,DiGirolamo DJ,et al.Insulin receptor signaling in osteoblasts regulates postnatal bone acquisition and body composition [J]. Cell,2010,142(3):309-319.\[13\]Basu R,Peterson J,Rizza R,et al. Effects of physiological1 variations in circulating insulin levels on bone turnover in humans [J]. J Clin Endocrinol Metab,2011,96(5):1450-1455.\[14\]Thomas DM,Udagawa N,Hards DK,et al. Insulin receptor expression in primary and cultured osteoclastlike cells[J]. Bone,1998,23(3): 181-186.\[15\]Akune T,Ohba S,Kamekura S, et al. PPARγ insufficiency enhances osteogenesis through osteoblast formation from bone marrow progenitor[J]. J Clin Invest,2004,113(6): 846-855.\[16\]Hawker G, Jamal S, Ridout R, et al. A clinical prediction rule to identify premenopausal women with low bone mass[J]. Osteoporos Int,2002,13(5):400-406.\[17\]Ho A, Kung A. Determinants of peak bone mineral density and bone area in young women[J]. J Bone Miner Metab,2005,23(6):470-475.\[18\]Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetesa metaanalysis[J]. Osteoporos Int,2007,18(4):427-444.\[19\]Reid I, Evans M, Cooper G, et al. Circulating insulin levels are related to bone density in normal postmenopausal women[J]. Am J Physiol Endocrinol Metab,1993,265(4):E655-E659.\[20\]Eriksson AL, MovérareSkrtic S, Ljunggren , et al. Highsensitivity CRP is an independent risk factor for all fractures and vertebral fractures in elderly men: the MrOS Sweden study[J]. J Bone Miner Res, 2014,29(2):418-423. |
|
|
|