Clinical analysis of bone mineral density in elderly patients with type 2 diabetes mellitus complicated with diabetic foot
10.3760/cma.j.issn.0254-9026.2009.05.007
- VernacularTitle:老年2型糖尿病合并糖尿病足患者骨密度的临床分析
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Diabetic foot;
Bone density;
Osteoporosis
- From:
Chinese Journal of Geriatrics
2009;28(5):383-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of bone mineral density (BMD) and its related factors in elderly patients with type 2 diabetes mellitus (T2DM) complicated with diabetic foot. Methods The BMD of lumbar vertebrae(L2～4) and femur were measured by dual energy X-ray absortiometry in 93 elderly T2DM patients complicated with diabetic toot (DF group), 153 elderly T2DM patients without diabetic foot(T2DM group) and 260 healthy elderly subjects(control group). The relationship between BMD and various factors, such as age, body mass index(BMI), course of disease, glycosylated hemoglobin (HbAlc), serum insulin, serum lipids, urinary albumin excretion rate, serum osteocalin and sex hormone were analyzed by multiple linear regression analysis. Results (1) The prevalence rate of osteoporosis and the values of BMD of L2～4 and femur in the T2DM group were similar to those in the control group(P>0. 05) . (2) In male DF group, the values of BMD of L2～4 and femur were markedly lower than those in the T2DM group and the control group(L2～ 4: (1.05±0.17) g/cm2vs. (1,13±0.17)g/cm2, and vs. (1.15±0.18) g/cm2;femur:(0.80± 0. 15) g/cm2vs. (0. 87±0. 13) g/cm2, and vs. (0. 90±0.16) g/cm2,all P<0.01];In female DF group, the values of BMD of L2～4 and femur were significantly decreased compared with those in the T2DM group and the control group (L2～4 : (0. 89±0. 11) g/cm2vs. (0. 96±0. 15)g/cm2, and vs. (0. 97±0. 14)g/cm2;femur: (0. 72±0. 13)g/cm2vs. (0. 78±0. 12)g/cm2, and vs. (0. 82±0. 15) g/cm2, all P<0. 05]. The prevalence rate of osteoporosis in the DF group was markedly higher than that in the T2DM group and the control group (male: 54% vs. 36%, 54% vs. 35%, both P<0. 05; female, 82% vs. 61%, 82% vs. 62%, both P<0.05). (3) Multiple linear regression analysis indicated that BMI and fasting serum insulin level were positively related to BMD and age was negatively related to BMD in male DF group. In female DF group, BMI and estradiol concentration were positively related to BMD and age was negatively related to BMD. Conclusions The prevalence rates of osteoporosis and the decreased BMD in T2DM patients were similar to those in healthy elderly subjects. The BMD was markedly lower and the prevalence rate of osteoporosis was significantly higher in DF patients than that in T2DM patients and healthy elderly subjects.
