الفهرس 
OsteoporosisOnly 14 pages are availabe for public view
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Abstract
Diabetic complications and osteoporotic fractures have many common features including genetic susceptibility, environmental factors and molecular mechanisms. Bone microarchitecture is compromised by T2DM through inducing abnormal bone cell function and matrix structure, with increased osteoblast apoptosis, diminished its differentiation, and enhanced osteoclast-mediated bone resorption.
The aim of this study was to assess the association of bone turnover markers and osteoporosis with T2DM microvascular complications.
To achieve our goal we selected 78 people with T2DM from the inpatients and outpatients clinics of the diabetes and endocrinology unit of Menoufia University Hospital.
They were categorized into 2 groups: 39 patients with T2DM with microvascular complications and 39 patients with T2DM without microvascular complications. The microvascular group was further categorized into 3 subgroups: microvascular 1, 2 and 3 according to the number of microvascular complications.
After taking a written consent, data as age, gender, duration of T2DM were obtained. Clinical examination was done with special emphasis on blood pressure, BMI, foot examination for signs of peripheral neuropathy and fundus examination for neuropathy.
Fasting blood sugar, two hours post prandial blood sugar using oral glucose tolerance test, serum Cr, blood urea, UACR, DEXA scan and serum OC were done to both the studied groups. Clinical, Laboratory data of the cases was tabulated.
Our results showed that kidney function tests (serum Cr, urea and UACR) were significantly higher in the microvascular group. Also, the duration of diabetes was significantly longer in that group. Additionally, diabetic retinopathy was more common in the microvascular group.
Serum OC level was significantly higher in microvascular group and its level increased significantly with the increase in the number of microvascular complications.
DEXA scan results showed that T-score decreased significantly with the increase in the number of microvascular complications.
There was significant correlation between least T-score and the kidney function tests (serum Cr and urea). Also, there was significant correlation between serum OC level and the kidney function tests (serum Cr, urea and UACR).
Uni- and multi-variate regression analysis showed that there was significant correlation between serum OC level and both serum Cr and UACR. ROC curve showed that the best cut off value of OC for diagnosis of osteopenia was 18 ng/ml, for diagnosis of microvascular complications was 2 ng/ml, for diagnosis of proteinuria was 20.8 ng/ml, while, for diagnosis of retinopathy was 21.6 ng/ml.