ArticleBMC endocrine disorders2026
Biochemical markers of bone metabolism and bone mineral density in patients with type 2 diabetic foot ulcer.
Article in BMC endocrine disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Type 2 diabetic foot ulcer (DFU) is closely linked to disorders of bone metabolism and abnormal bone mineral density (BMD), while serum 25-hydroxyvitamin D [25(OH)D], the gold standard for evaluating Vit D nutritional status, acts as an independent protective factor for DFU and is implicated in skeletal health regulation in diabetic patients. This cross-sectional study aimed to investigate biochemical markers of bone metabolism and BMD in patients with type 2 diabetic foot ulcer, and to identify risk factors for diabetic foot and accompanying gangrene. A total of 400 patients with type 2 diabetes mellitus (T2DM) admitted to the Endocrinology Ward of Affiliated Hospital of Nantong University from December 2021 to May 2023 were enrolled, including 155 in the DF group and 245 in the non-diabetic foot (NDF) group. Clinical data, bone metabolism markers and BMD measured by dual-energy X-ray absorptiometry (DXA) were collected, and data were analyzed using SPSS 25.0 software. Compared with the NDF group, the DF group had older age, longer diabetes duration, higher systolic blood pressure (SBP), urinary albumin creatinine ratio (UACR) and type I collagen N-terminal propeptide (PINP) level, but lower levels of serum albumin (ALB), glycemic and lipid indicators, 25(OH)D, total BMD and hip regional B < 0.05), with a significantly higher prevalence of low bone mass and osteoporosis. Binary logistic regression revealed that elevated SBP, reduced ALB, lower total T-score and total body fat content were independent risk factors for DF, with optimal cutoff values of 140 mmHg, 34.9 g/L, - 0.5 and 27.5% respectively. Additionally, lower BMD at the femoral shaft, femoral neck and greater trochanter was significantly associated with an increased risk of gangrene in DF patients. In conclusion, patients with type 2 diabetic foot ulcer present significant bone metabolism disorders and reduced BMD, and decreased BMD and related metabolic indicators can serve as valuable markers for predicting DF and its gangrene progression, providing clinical evidence for the early prevention and targeted treatment of this condition.
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