Objective To investigate the changes in thyroid hormone and glucose levels and their correlation with bone density and microangiopathy in elderly patients with type 2 diabetes mellitus（T2 DM）. Methods Eighty-six elderly T2 DM patients admitted to a hospital in Sichuan from June 2017 to June 2019 were selected and divided into normal bone mass（n=34）

reduced bone mass（n=32） and osteoporosis（n=20） groups according to the WHO osteoporosis diagnostic criteria; based on whether the patients had diabetic neuropathy

diabetic nephropa-thy or diabetic retinopathy

they were divided into microangiopathy（n=23） and microangiopathy-free（n=63） groups as well. The levels of thyroid hormones [thyroid-stimulating hormone（TSH） in serum

free triiodothy-ronine（FT3）

and free thyroxine（FT4）] were compared across the normal bone mass group

the reduced bone mass group

and the osteoporosis group

as well as between the microangiopathy group and the microangiopathy-free group. The correlation between microangiopathy and the levels of thyroid hormones and bone density in eld-erly T2 DM patients was also analyzed. Results The differences in TSH

fasting blood glucose（FBG） and hemo-globin A1 c（Hb A1 c） levels of patients in the normal bone mass group

reduced bone mass group and osteoporosis group were statistically significant（P<0.05）; the serum TSH

FBG and Hb A1 c levels of patients in the osteo-porosis group were higher than those in the reduced bone mass group and normal bone mass group

and the TSH

FBG and Hb A1 c levels of patients in the reduced bone mass group were higher than those in the normal bone mass group

and the differences were all statistically significant（P<0.01）. The levels of TSH

FBG and Hb A1 c were higher in the microangiopathy group than in the microangiopathy-free group

and the femoral neck and orthotopic lumbar（L1-4） T values were lower than those in the microangiopathy-free group

and the differ-ences were all statistically significant（P<0.05）. TSH levels in patients with T2 DM were significantly and negatively correlated with bone density while significantly and positively correlated with microangiopathy（P<0.05）. FBG and Hb A1 c levels in patients with T2 DM were significantly and positively correlated with both bone density and microangiopathy in patients（P<0.05）. Conclusion TSH

FBG and Hb A1 c levels in elderly patients with T2 DM were strongly correlated with bone density and microangiopathy

and active monitoring of TSH

FBG and Hb A1 c levels in patients with T2 DM may provide reference for the prediction of bone density changes and mi-croangiopathy