The Relationship between Blood Glucose Variability,Low-Density Lipoprotein,and the Onset of Osteoporosis in Postmenopausal Patients with Type 2 Diabetes Mellitus
Objective To investigate the relationship between blood glucose variability,low-density lipoprotein cholesterol(LDL-C),and the onset of osteoporosis(OP)in postmenopausal patients with type 2 diabetes mellitus(T2DM).Methods A total of 226 postmenopausal T2DM patients admitted to The First People's Hospital of Ruzhou from April 2020 to December 2022 were selected as the research subjects.General information of the patients was collected,and fasting venous blood was collected to test blood glucose,blood lipids,thyroid hormone levels,and bone metabolism indicators[blood calcium,blood phosphorus,alkaline phosphatase(ALP),N-terminal propeptide of type 1 precollagen(P1NP),and β-collagen degradation product(β-CTx)].Continuous blood glucose monitoring was performed on the patients,and blood glucose variability parameters[mean amplitude of glycemic excursions(MAGE),coefficient of variation of blood glucose(CV),24-hour mean blood glucose level(MBG),and standard deviation of blood glucose level(SDBG)]were calculated.The bone density of the patients was measured by X-ray absorption method.According to the test results,the patients were divided into normal bone mass group(n=73),reduced bone mass group(n=86),and OP group(n=67).The clinical data,bone metabolism indicators,and blood glucose variability indicators of the three groups were compared.The Spearman correlation coefficient was used to analyze the correlation between blood glucose variability,LDL-C,and the onset of disease in postmenopausal T2DM patients.Results There were statistically significant differences in the duration of T2DM,serum total cholesterol(TC),LDL-C,high-density lipoprotein cholesterol(HDL-C),and uric acid(UA)levels among the three groups(P＜0.05).There were no statistically significant differences in age,body mass index(BMI),complications,fasting blood glucose(FPG),fasting C-peptide,serum triglyceride(TG),triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)levels(P＞0.05).The serum levels of blood calcium,blood phosphorus,ALP,and P1NP in the OP group and the reduced bone mass group were significantly lower than those in the normal bone mass group,and the β-CTx level was significantly higher than that in the normal bone mass group,with statistically significant differences(P＜0.05).The serum levels of ALP and P1NP in the OP group were significantly lower than those in the reduced bone mass group,and the β-CTx level was significantly higher than that in the reduced bone mass group,with statistically significant differences(P＜0.05).The levels of MAGE,CV,and SDBG in the OP group and the reduced bone mass group were significantly higher than those in the normal bone mass group,with statistically significant differences(P＜0.05).The levels of MAGE,CV,and SDBG in the OP group were significantly higher than those in the reduced bone mass group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the comparison of MBG levels among the three groups(P＞0.05).Spearman correlation coefficient analysis showed that the blood glucose variability parameters(MAGE,CV,SDBG)and serum LDL-C level were significantly positively correlated with the onset of osteoporosis in postmenopausal T2DM patients,which was statistically significant(P＜0.05).Conclusion LDL-C and blood glucose variability parameters(MAGE,CV,SDBG)in postmenopausal T2DM patients are significantly correlated with the onset of osteoporosis.Testing these indicators is beneficial for the early diagnosis of OP in postmenopausal T2DM patients.
Type 2 diabetes mellitusblood glucose variabilityLow-Density lipoprotein cholesterolosteoporosiscorrelation
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