A Correlation Study Between Blood Glucose Fluctuations,Bone Turnover Markers,and Bone Mineral Density in Elderly Male Patients with Type 2 Diabetes
Objective To investigate the correlation between indicators related to blood glucose fluctuations and bone metabolism and bone mineral density in elderly male patients with type 2 diabetes mellitus(T2DM).Methods A total of 252 elderly male patients with T2DM who were treated in the Endocrinology Department of the First Affiliated Hospital of Anhui Medical University from September,2020 to March,2023 were selected for the current study.These patients were divided into three groups based on their bone mineral density results:normal group,osteopenia group,and osteoporosis group.Clinical information,physical examination results,and laboratory examination records of these patients were collected.All subjects underwent continuous glucose monitoring(CGM)for 72 hours,and indicators related to blood glucose fluctuations were collected.T-tests or variance tests were applied to compare the general clinical data and laboratory results among the three groups.Pearson correlation analysis and multiple regression analysis were used to explore the correlation between indicators related to blood glucose fluctuations and bone metabolism and bone mineral density.Results With the severity of bone loss increased,the age and duration of disease history of patients significantly increased,while BMI significantly decreased.The proportion of patients using GLP-1 receptor agonists in the osteoporosis group significantly decreased.Bone formation indicators OC and PINP,as well as bone resorption indicators CTX and TRAP,significantly decreased.Indicators related to blood glucose fluctuations such as TIR,SDBG,CV MAGE,and MODD significantly increased with the severity of bone loss in patients.In addition,Pearson correlation analysis and multiple regression analysis showed that OC was significantly and independently negatively correlated with CV MAGE,and MODD,while CTX was significantly and independently negatively correlated with TIR,CV and MAGE.TRAP was significantly and independently negatively correlated with MAGE.T-score of the femoral neck and total hip were significantly and independently negatively correlated with MAGE.Conclusion This study shows that there is an independent negative correlation between indicators related to blood glucose fluctuations and bone turnover markers and bone mineral density in elderly male patients with T2DM.Therefore,positive control of blood glucose fluctuations in elderly male patients with T2DM could be beneficial for improving bone metabolism and bone mineral density.
Type 2 diabetes mellitusBlood glucose fluctuationsContinuous glucose monitoringBone turnover markersBone mineral density
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