2023, Vol. 27 ›› Issue (31): 5009-5014

Correlation between new sarcopenia index and bone mineral density in postmenopausal patients with type 2 diabetes mellitus

Gu Peng1, Pu Bin1, Chen Junbang1, Yue Dan2, Xin Qiao3, Zeng Zhanpeng4, Zheng Xiaohui4   

Abstract: BACKGROUND: The prevalence of type 2 diabetes mellitus complicated with osteoporosis is increasing yearly. Early prevention, detection, and treatment of osteoporosis are considered essential in postmenopausal patients with type 2 diabetes mellitus.
OBJECTIVE: To investigate the correlation of new sarcopenia index (SI) with bone mineral density and osteoporosis in patients with type 2 diabetes mellitus complicated with osteoporosis.  
METHODS: Postmenopausal patients with type 2 diabetes mellitus hospitalized in the First Affiliated Hospital, Guangzhou University of Chinese Medicine from January 2021 to March 2022 were selected and divided into osteoporosis group (n=93) and non-osteoporosis group (n=121) according to whether type 2 diabetes mellitus is combined with osteoporosis. The demographic data, bone mineral density, blood routine, glucose metabolism, lipid metabolism, and renal function indexes were collected and the SI was calculated. The correlation between clinical indexes and bone mineral density of the lumbar spine, left femoral neck and left hip was analyzed by multivariate linear regression, and the risk factors of osteoporosis in postmenopausal patients with type 2 diabetes mellitus were analyzed by multivariate logistic regression. The predictive values of new SI, serum cystatin C level, and creatinine/serum cystatin C ratio (CCR) in predicting osteoporosis in postmenopausal patients with type 2 diabetes mellitus were analyzed by the receiver operating characteristic curve.  
RESULTS AND CONCLUSION: (1) The new SI, serum cystatin C level, and CCR value in the osteoporosis group were lower than those in the non-osteoporosis group (P < 0.05). (2) Multivariate linear regression analysis with adjusted covariates showed that the new SI and CCR were significantly positively correlated with bone mineral density of the lumbar spine, left femoral neck and left hip (βCCR=0.003, 0.001, 0.002, P < 0.05; βSI=0.002, 0.001, 0.002, P < 0.05). The cystatin C level was significantly correlated with bone mineral density of the lumbar spine (βcystatin C=0.09, P < 0.05). (3) Multivariate Logistic regression analysis with adjusted covariates showed that serum cystatin C level, CCR, and new SI were protective factors for osteoporosis in postmenopausal patients with type 2 diabetes mellitus (odds ratio=0.149, 0.957, 0.941; P < 0.05). (4) The area under the receiver operating characteristic curve of the new SI for predicting osteoporosis in such patients was the largest (the area under the curve=0.756), with a sensitivity of 67.8% and a specificity of 72.0%. (5) To conclude, renal function is intrinsically related to bone health. An increased new SI is related to the increase of bone mineral density in postmenopausal patients with type 2 diabetes mellitus, and the risk of osteoporosis can be predicted by the new SI in such patients.

Key words: type 2 diabetes mellitus, osteoporosis, bone mineral density, new sarcopenia index, postmenopausal woman