Correlation between serum uric acid level and bone mineral density and FRAX score in middle-aged and elderly patients with type 2 diabetes mellitus
Objective To investigate the relationship between serum uric acid level and bone mineral density and fracture risk as-sessment tool(FRAX)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 467 middle-aged and elderly patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,Xinjiang Uygur Autonomous Region People's Hospital from June 2020 to October 2020 were selected.Bone mineral density(BMD)of the distal third of radius,lum-bar L1-4 and femoral neck were measured,and the fracture risk with or without femoral neck BMD was calculated.The relationship be-tween serum uric acid level and bone mineral density and FRAX score was analyzed,and the sensitivity and specificity of serum uric acid in predicting osteoporosis in postmenopausal women with T2DM and the optimal cut-off point of serum uric acid were evaluated by AUC curve.Results With the increase of SUA level,height,weight,distal radius 1/3BMD,L1-4BMD,Cr,BUN,TC were signifi-cantly increased.With the increase of SUA level,the female proportion,HbA1c,distal radius 1/3BMD(T)and L1-4BMD(T)were sig-nificantly decreased(all P＜0.05).There was no significant correlation between SUA and BMD and FRAX score in males.SUA was posi-tively correlated with distal radius 1/3BMD and L1-4BMD in postmenopausal women(r=0.132 & 0.155,P＜0.05).However,there was no significant correlation between BMD and femoral neck BMD,PMF-FRAXwithout BMD,PHF-FRAXwithout BMD,PMF-FRAXwith BMD,and PHF-FRAX with BMD.Multiple linear regression analysis showed that after adjusting for age,HDL,Ca,P,25(OH)D confounding factors,SUA was still a protective factor for 1/3BMD and L1-4BMD of postmenopausal female distal radius(adjusted R2=0.035-0.205,P＜0.05).The area under the ROC curve AUC of serum uric acid for predicting osteoporosis in postmenopausal women with T2DM was 0.569,the cut-off value of SUA was 325/(μmol/L),the sensitivity was 68％,the specificity was 48％,and there was no statistical sig-nificance.Conclusion Serum uric acid is positively correlated with bone mineral density in postmenopausal patients with type 2 dia-betes mellitus.A slightly higher level of serum uric acid may help postmenopausal women with type 2 diabetes mellitus maintain bone mass.Serum uric acid was neither a protective factor nor a risk factor for FRAX score.
Type 2 diabetes mellitusUric acidBone mineral densityFracture risk assessment toolFRAX.osteoporosis
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