2型糖尿病患者血清尿酸/白蛋白比值与骨密度及10年骨折风险的相关性OA

Objective To investigate the association of the serum uric acid to albumin ratio(UAR)with bone mineral density(BMD)and 10-year fracture risk in patients with type 2 diabetes mellitus(T2DM),stratified by sex and age.Methods This retrospective study included 835 hospitalized patients with T2DM who were admitted to the Department of Endocrinology of Shandong Provincial Hospital between September 2023 and December 2024.BMD at the femoral neck(FN),total hip(TH)and lumbar spine(LS)was measured by dual-energy X-ray absorptiometry(DXA).The 10-year probabilities of major osteoporotic fracture(MOF)and hip fracture(HF)were estimated using the fracture risk assessment tool(FRAX).Participants were stratified into three groups according to BMD T-scores:T-score≥-1.0,-2.5＜T-score＜-1.0,and T-score≤-2.5.They were also divided into four groups according to UAR quartiles(Q1-Q4)and further stratified by age into＜60 years and≥60 years groups.Results With increasing UAR quartiles,BMD at the FN,TH and LS showed an upward trend,whereas the predicted probabilities of FRAX-MOF and HF showed a downward trend(all P≤0.001).In the overall population,UAR was significantly positively correlated with BMD at the three sites and significantly negatively correlated with fracture risk.Subgroup analyses showed that these associations were most pronounced in younger men,while in women UAR was mainly positively associated with BMD,and the associations were weaker in older men.Multivariable logistic regression analysis demonstrated that UAR had an independent negative correlation with osteoporosis in patients with T2DM(OR=0.886,95%CI:0.799-0.983,P=0.022).Conclusion In patients with T2DM,higher UAR levels are independently associated with higher BMD and lower FRAX-estimated 10-year fracture risk.UAR may serve as a simple biomarker for the preliminary prediction of bone mass abnormalities in patients with T2DM.