Objective To explore the correlation between serum uric acid level and bone metabolic markers, bone mineral density, and osteoporosis in elderly patients with type 2 diabetes mellitus. Methods From 2018 to 2019, 577 elderly patients with type 2 diabetes mellitus aged over 60 years old were selected, including 289 males and 288 females (all postmenopausal females). The general clinical data were investigated. Biochemical indexes and levels of parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH-D), osteocalcin (OC), serum procollagen type I N-terminal propeptide (P1NP), and collagen type I cross-linked C-terminal peptide (beta-CTX) were determined. Glomerular filtration rate (eGFR) and dual energy X-ray absorption were calculated and estimated. Bone mineral density (BMD) of the femoral neck (FN) and lumbar spine (L1-4) was measured with DXA. The trend of total BMD of the femoral neck and lumbar spine was analyzed with SUA quartile method. The relationship between SUA and blood calcium (Ca), PTH, OC, P1NP, CTX, 25-OH-D, and BMD of the lumbar spine and femoral neck was analyzed using Pearson and Pearman correlation analysis. The relationship between SUA and osteoporosis was analyzed with multivariate logistic regression. Results BMI, creatinine (Cr), and BMD of the femoral neck and lumbar spine in SUA group 4 were significantly higher than those in subgroup 1. eGFR levels in SUA group 4 were significantly lower than those in subgroup 1 (P<0.05). Pearson correlation analysis showed that SUA was positively correlated with BMD of the femoral neck (r=0.082, P=0.002), duration of diabetes mellitus (r=0.129, P=0.05), and BMI (r=0.201, P=0.000), but was negatively correlated with eGFR (r=-0.434, P=0.000). Spearman correlation analysis showed that SUA was positively correlated with BMD of total lumbar spine (r=0.168, P=0.003) and Ca (r=0.147, P=0.001) and negatively correlated with beta-CTX (r=-0.157, P=0.001), and there was no correlation with PTH, 25-OH-D, OC, and P1 (P>0.05). With osteoporosis as dependent variable, multivariate logistic regression showed that after adjusting age, eGFR, BMI, and HbA1c, high level of SUA was the protective factor for osteoporosis (P=0.039, OR=0.452, 95% CI: 0.212-0.962). Conclusion Normal or slight high serum level of uric acid may reduce the risk of osteoporosis in elderly patients with type 2 diabetes mellitus. |