Changes of bone mineral density and metabolism in patients with type 2 diabetes mellitus of different traditional Chinese medicine syndrome types

Weiguo XU; Zhenjia YI

ABSTRACT

BACKGROUND:

Abnormal changes of bone mineral density (BMD) easily occur in patients with non-insulin-dependent diabetes mellitus (NIDDM),however the mechanisms are still unclear.

OBJECTIVE:

To investigate the pathophysiological features of changes of BMD and metabolism in patients with NIDDM from the angle of traditional Chinese medicine (TCM) syndrome types.

DESIGN:

A case controlled and comparative observation.

SETTING:

Department of Endocrinology of Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA

PARTICIPANTS:

Totally 103 cases (55 males and 48 females) of patients with NIDDM admitted in Department of Endocrine of Guangzhou General Hospital of Guangzhou Military Area Command of PLA from April 2003 to April 2004 were enrolled. They were, according to TCM syndrome types, divided into 3 groups yin deficiency with heat excess (32 cases),deficiency of both qi and yin (36 cases), and deficiency of both yin and yang (35 cases) groups. The healthy persons of 30 staff, 16 males and 14 females, in the hospital were concurrently recruited as control group. Informed consent was obtained from all the subjects.

METHODS:

①A dual-energy X-ray absorption meter was used to determine the bone mineral densities of orthophoric 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ② Radioimmunoassay was taken to measure the content of serum osteocacin (OC). ③Colorimetry was used to measure the level of serum tartrate resistant acid phosphatase (TRACP). ④ q-test and x2-test were respectively used for comparison of measurement and enumeration data.MAIN OUTCOME

MEASURES:

①The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ②The morbidities of osteoporosis of subjects in each group. ③ The levels of OC and TRACP in each group.

RESULTS:

All 103 NIDDM patients and 30 healthy subjects entered the final result analysis. ① The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip of

subjects:

The BMD in yin deftciency with heat excess, deficiency of both qi and yin and control groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.05-0.01 ) ② The morbidity of osteoporosis The morbidities of osteoporosis in yin deficiency with heat excess, deficiency of both qi and yin and control groups were obviously lower than that in deficiency of both yin and yang group[34%(ll/32),42% (15/36), 33% (10/30), 71% (25/35),P ＜ 0.01]. ③ The level of OC The levels in yin deficiency with heat excess and deficiency of both qi and yin groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.01 ), but lower than that in deficiency of both yin and yang group (P ＜ 0.05). ④ The level of TRACP There was no significant difference among groups(P ＞ 0.05).

CONCLUSION:

① The volume and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were obviously lower than those in healthy persons and NIDDM patients of yin deficiency with heat excess and deficiency of both qi and yin syndrome types, and the osteoporosis morbidity in them was obviously higher than those in healthy persons and the other two syndrome-type patients. ② The quantity and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were near to those in healthy persons.