Relationship Between α-Glucosidase Inhibitors Application and Bone Mineral Density in Chinese Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Xiumei Luo,1,2 Shangjian Li,1,2 Ning Chen1,2 1Department of Endocrinology, Fudan University Zhongshan Hospital Xiamen Branch, Xiamen, Fujian, People’s Republic of China; 2Xiamen Osteoporosis Specialized Prevention and Treatment Center, Xiamen, Fujian, People’s Republic of ChinaCorrespondence: Ning Chen, Department of Endocrinology, Zhongshan Hospital (Xiamen), Fudan University, No. 668 Jinhu Road, Xiamen, 361000, People’s Republic of China, Tel/Fax +86-0592-3569583, Email [email protected]: To investigate the correlation between α-glycosidase inhibitors (AGIs) and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 251 patients with T2DM admitted to the Zhongshan Hospital, Fudan University (Xiamen Branch) from September 2018 to September 2020 were enrolled. Baseline information of patients was analyzed according to different BMD subgroups. Clinical characteristics and BMD were compared between AGIs Group (n = 58) and non-AGIs group (n = 193). Multiple linear regression model was used to examine the relationship between AGIs application and BMD.Results: The lower BMD group showed the characteristics of older age, longer duration of diabetes, lower body mass index (BMI) and estradiol (E2). In the AGIs group, the proportion of females, duration of diabetes, incidence of diabetic peripheral vascular disease and the use of sulfonylureas were significantly higher than those in the non-AGIs group (p < 0.05), the results of HbA1c, TC, TG, LDL, FT3, FT4 were opposite (p < 0.05). Compared with the non-AGIs group, the BMD of femoral neck and lumbar spine in the AGIs group was significantly decreased, FRAX score and the prevalence of osteoporosis were remarkably increased, accompanied by a decrease in β-CTX and P1NP level. Multivariate linear regression analysis showed a significant negative correlation between AGIs and lumbar BMD after adjustment for potential confounding variables (β = − 0.053, 95% CI − 0.100~0.006, P = 0.029).Conclusion: This study indicates that the use of AGIs in patients with T2DM is significantly associated with an increased risk of BMD decline, osteoporosis, and fracture.Keywords: type 2 diabetes mellitus, α-glucosidase inhibitor, BMD, osteoporosis