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| 中老年2型糖尿病患者骨密度与尿酸、胰岛素抵抗关系的研究 |
| Bone mineral density is associated with uric acid and insulin resistance in elderly patients with type 2 diabetes |
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| DOI：10.3969/j.issn.1006.7108.2016.03.019 |
| 中文关键词: 2型糖尿病 骨密度 尿酸 胰岛素抵抗指数 |
| 英文关键词:Type 2 diabetes Bone mineral density Uric acid Homestasis model assessment for insulin resistance(HOMA-IR) |
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| 中文摘要: |
| 目的 探讨中老年2型糖尿病患者骨密度与尿酸、胰岛素抵抗的关系。方法 根据制定的纳人标准和排除标准，人选了152例中老年2型糖尿病患者，男性组（n =68)和绝经后女性组（n= 84),两组年龄、体重指数、糖尿病病程具有均衡性，比较两组代谢组分、各部位骨密度（BMD)及骨代谢指标;Pearson相关分析及多元逐步回归分析探讨各部位BMD及骨代谢指标 与尿酸、胰岛素抵抗指数（HOMA-IR)的关系。结果 两组尿酸、股骨颈、大粗隆、粗隆间、Wards区、腰椎（L1-4)各部位BMD及骨代谢指标有显著性差异。中老年2型糖尿病患者各关节BMD均与尿酸、HOMA-IR呈正相关;男性组各部位BMD与尿酸呈正相关;绝经后女性组各部位BMD与尿酸、HOMA-IR呈正相关。回归分析示尿酸是影响男性L3部位骨密度和β-CTX的独立因素；HOMA-IR是影响女性髋关节和腰椎骨密度的独立因素。结论 尿酸可能增加中老年男性2型糖尿病患者的骨密度值，胰岛素抵抗对中老年女性患者维持骨量及促进骨合成可能具有正向调节作用。 |
| 英文摘要: |
| Objective To investigate the association between uricacid and bone mineral density in elder people with type 2 diabetes. Methods According to the admission and exclusion standards, 152 elderly patients with type 2 diabetes were enrolled, which were divided into the male group (n= 68) and the postmenopausal female group (n =84). The average ages, body mass indexs and the durations of diabetes in the two groups were balanced and the metabolic parameters including uric acid and homestasis model assessment for insulin resistance (HOMA-IR), bone mineral density (BMD) and bone metabolism parameters between the two groups were compared. The relationship of the metabolic parameters and bone mineral density was analyzed using Pearson correlation analysis and stepwise multiple regression analysis. Results There were significantly differences in the uric acid, BMD at all sites including femoral neck, trochanter, inter tuberosity, Ward’s triangle and lumbar spine , and bone metabolism parameters between the two groups. In elder people with type 2 diabetes, the BMD of each joint was positively correlated with uric acid and HOMA-IR. The BMD was positively correlated with uric acid in male group. In postmenopausal famale group, the BMD were positively correlated with uric acid and HOMA-IR. Regression analysis show the uric was an independent relevant factor affecting the BMD of L3 and β-C-terminal telopeptide of type I collagen(β-CTX) in male group. In postmenopausal famale group, HOMA-IR was an independent relevent factor affecting BMD at hip and lumbar spine. Conclusions Uric acid level may increase BMD in elder men with type 2 diabetes，and in postmenopausal famale patients, insulin resistance may be a positive regulatory to BMD. |
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