Objective To explore and analyze the correlation between vasoactive intestinal peptide and bone metabolism and osteoporosis in elderly type 2 diabetic patients. 〖WTHZ〗Methods We selected 86 elderly patients with type 2 diabetes who were admitted to our hospital from February 2020 to February 2021. A dual-energy X-ray bone densitometer was used to measure the bone mineral density of the patients, and the patients were divided into type 2 diabetes mellitus combined with osteoporosis group 35 cases, type 2 diabetes mellitus combined with osteopenia group 30 cases, and type 2 diabetes bone mass according to their bone density. There were 21 cases in the normal group. Enzyme-linked immunosorbent assay was used to determine the level of vasoactive intestinal peptide in the patient’s serum, and analyze the relationship between changes in the level and bone metabolism and osteoporosis. Results The levels of vasoactive intestinal peptide, lumbar bone mineral density, femoral neck bone mineral density and PINP in the osteoporosis group and the osteopenia group were significantly lower than those in the normal bone mass group, while the levels of CTX were significantly higher than those in the normal bone mass group, and the differences between the groups were statistically significant (P<0.05). Pearson correlation analysis showed that vasoactive intestinal peptide was positively correlated with PINP (r=0.427, P<0.05) and negatively correlated with CTX (r=-0.369, P<0.05). Vasoactive intestinal peptide was positively correlated with femoral neck BMD (r=0.418, P<0.05). P<0.05), and had a positive correlation with lumbar bone mineral density (r=0.374, P<0.05). Multivariate Logistic regression analysis showed that femoral neck bone mineral density (OR=1.436, 95%CI:1.07-1.923), lumbar spine bone mineral density (OR=1.608,95%CI: 1.039-2.489), PINP (OR=1.696, 95%CI:1.061-2.709), CTX (OR=1.598,95%CI: 1.045-2.446), VIP (OR=1.694, 95%CI: 1.243-2.309) were independent risk factors for bone metabolism and osteoporosis in patients with type 2 diabetes mellitus (P<0.05). Conclusion Vasoactive intestinal peptide is positively correlated with osteoporosis in elderly type 2 diabetic patients, and negatively correlated with bone metabolism. Testing the level of vasoactive intestinal peptide can understand the bone mineral density and bone metabolism of type 2 diabetic patients, and then help bone quality Treatment and prevention of porosity