Objective:To investigate the changes of serum miR-210, miR-30a and miR-16 in patients with type 2 diabetes mellitus (T2DM) combined with osteoporosis (OP) and to analyze the influencing factors.Methods:Eighty patients with T2DM admitted to our hospital from May. 2019 to May. 2022 were prospectively selected for the study, and the patients were divided into 42 patients with T2DM combined with OP and 38 patients with T2DM without OP according to whether the patients were combined with OP. Another 40 cases were selected as the control group during the same period of physical examination. We compared the differences of miR-210, miR-30a and miR-16 among the groups, and analyzed the diagnostic value of miR-210, miR-30a and miR-16 on T2DM combined with OP by ROC curve, and analyzed the influencing factors of T2DM combined with OP by binary logistic regression. miR-210, miR-30a and miR-16 were analyzed by Spearman correlation. Spearman correlation analysis of miR-210, miR-30a, miR-16 and T2DM combined OP related indexes.Results:The differences of miR-210, miR-30a, and miR-16 were statistically significant between groups ( F=24.13, 62.69, 307.26, P<0.05), and the control group < T2DM uncomplicated OP group < T2DM combined OP group ( P<0.05). ROC curve analysis showed that miR-210, miR-30a, and miR-16 The AUCs for the diagnosis of T2DM combined with OP were 0.779, 0.854 and 0.973 in order, all of which had some accuracy in diagnosis. Binary logistic multi-factor regression analysis showed that the duration of T2DM disease, glycosylatedhemoglobin (HbA1c), type I collagen carboxy-terminal peptide β special series (β-CTX) were all risk factors for T2DM combined with OP ( P<0.05), body mass index (BMI. BMI, parathyroid hormone (PTH), 25-hydroxyvitamin D3monohydrate (25 (OH) D3), bone Gla protein (BGP), bone mineral density (BMD) were all risk factors for T2DM combined with OP ( P<0.05). Spearman correlation analysis showed that miR-210, miR-30a and miR-16 were negatively correlated with BGP and BMD ( r=-0.668/-0.592/-0.599, -0.671/-0.609/-0.593) and positively correlated with β-CTX ( r=0.670/0.603/0.605) . Conclusion:miR-210, miR-30a and miR-16 are highly expressed in the serum of patients with T2DM combined with OP, and the duration of T2DM, HbA1c and β-CTX were all risk factors for T2DM combined with OP, and BMI, PTH, 25 (OH) D3, BGP and BMD are all protective factors for T2DM combined with OP.