Objective To investigate the correlation between telomere length of peripheral white blood cells and the levels of advanced glycosylation end products,as well as bone mineral density in patients with type 2 diabetes mellitus,and to assess the impact of advanced glycosylation end product levels on telomere length.Methods From May 1,2023,to May 1,2024,174 patients with T2DM who underwent dual-energy X-ray BMD examination at the Department of Endocrinology,Zhengzhou Central Hospital,were selected.T2DM patients were divided into osteoporosis group,osteopenia group,and normal bone mass group based on the T-value in BMD.qPCR method was used to measure telomere length in peripheral blood leukocytes,and ELISA method was used to determine AGEs levels.General patient data were collected along with measurements for blood glucose,blood lipid levels,25-hydroxy-vitamin D,and other indicators.Bone mineral density was evaluated using dual-energy X-ray imaging while plasma CTX and PINP levels were measured via ELISA.SPSS 26.0 statistical software was utilized to analyze differences and correlations among all indicators.Results(1)The telomere length of OP group,osteopenia group and normal bone mass group was different,and the telomere length of the three groups increased successively.(2)In individuals with type 2 diabetes mellitus,telomere length exhibited a positive correlation with BMD and a negative correlation with CTX and PINP.Plasma AGEs level showed a negative correlation with BMD and a positive correlation with CTX and PINP,while telomere length demonstrated a negative correlation with AGEs level.(3)Telomere length was an independent factor of BMD,and AGEs level was an independent factor of BMD(P<0.05).Conclusion The reduction of telomere length and the increase of AGEs in patients with type 2 diabetes are related to the decrease of bone mineral density,and the reduction of telomere length is related to the increase of AGEs.Telomere length of peripheral leucocytes and plasma AGEs level can jointly evaluate the bone metabolism status of T2DM patients.