The patients with type 2 diabetes (T2DM) have higher fracture risk, and this study is conducted to identify the contributors of the abnormal bone turnover in newly diagnosed T2DM patients and to set a prediction model for osteoporosis in this population. This retrospective study includes 244 newly diagnosed patients with T2DM and 218 individuals without diabetes. Demographic characteristics, clinical history, biochemical indexes, bone turnover markers were detected. BMD was measured by DEXA. SPSS 20.0 software is hired for statistical analysis. Comparing to the patients without diabetes, the patients with T2DM have lower levels of P1NP, CTX, OC, PTH, 25(OH)D and higher level of BALP. The patients with T2DM have higher BMD in lumbar, femur neck and total hip comparing to the controls. In T2DM group, HbA1c level is negatively related to P1NP and OC, and total cholesterol is positively related to BALP, independently. In the patients without diabetes, HbA1c level is negatively related to the level of OC and positively related to 25(OH)D, and HDL is positively related to P1NP, independently. The level of PTH is negatively related to HbA1c in all the participants. After adjusted with age, BMI and menopausal status, BALP and OC were positively correlated with the risk of osteoporosis in all the participants, moreover in the patients with T2DM, HbA1c, TRAP5b and P1NP were also positively correlated with the onset of osteoporosis. The prediction model including age, BMI, menopausal status, TRAP-5b and OC for osteoporosis in T2DM patients had the area under the ROC curve as 0.817 with the sensitivity and specificity at 70% and 82% respectively. The above data indicate that increased glucose level contributes to impaired maturation of osteoblasts, and the prediction model including age, BMI, menopausal status and bone turnover markers may find out the T2DM patients with high fracture risk. However, this result needs to be proven with fracture data.
L. Song: None. H. Li: None. Y. Wen: None. X. Zhang: None. P. Liu: None.
Shanghai Municipal Health Commission (201840217 to L.S.); Clinical Science and Technology Innovation Program of Hospital Development Center (SHDC12018X10 to L.S.); Tongji Hospital (ITJ(ZD)1904 to L.S.); Fundamental Research Funds for the Central Universities of Tongji University (22120180355 to L.S.); Shanghai Science and Technology Foundation (19ZR1448600 to L.S.)