中国骨质疏松杂志

2型糖尿病男性不同年龄阶段骨密度变化特点及分析

The characteristics of bone mineral density in men of different ages with type 2 diabetes

DOI：10.3969/j.issn.1006.7108.2016.05.013

英文关键词:Type 2 diabetes Male Bone mineral density Osteoporosis

基金项目:

作者	单位
赵镇薄亚文叶新华* 成金罗	南京医科大学附属常州第二人民医院内分泌科，常州213000

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中文摘要:

目的探讨2型糖尿病男性患者不同年龄阶段骨密度的特点及相关影响因素。方法回顾性分析2013年-2014年在我院进行骨密度检查的444例2型糖尿病男性及208例健康对照组男性。采用美国双能X线骨密度仪对所有男性的腰椎 (L1-4)、左侧股骨近端（Neck)、大转子（Torch)、华氏三角（Ward’s)和髋部总体（Htot)的骨密度（bone mineral density, BMD)进行测量。糖尿病组患者按每10岁分段，比较各年龄段间BMD的变化。同时将糖尿病组和对照组按每5岁进行分段，比较糖尿病组与同龄对照组BMD的差异。将糖尿病组不同部位的BMD与体重指数（BMI)、糖尿病病程、肌酐（Cr)、血清钙（Ca)、磷 (P)、总胆固醇（TC)、甘油三酯（TG)进行相关性分析。结果（1）糖尿病组组内比较：Neck和Ward’s三角的BMD在不同年龄段间存在统计学差异（P<0.05)。（2)糖尿病组与对照组比较:①40 ~44岁年龄段两者在Ward’s三角的BMD存在统计学差异（P <0.05)。②45~59岁年龄段两组之间不同部位的BMD无统计学差异（P > 0. 05)。③60 ~ 64岁年龄段两组在L1、 L2、Torch、Neck及Htot部位的BMD存在差异（P <0. 05)。④65 ~69岁年龄段两组在L1、L2、L3、L4、Neck、Htot部位的BMD存在统计学差异。60 ~69岁年龄段糖尿病组各部位的BMD均髙于对照组（P>0.05)。（3）相关性分析：男性T2DM患者的 L1BMD与BMI、肌酐、血钙成正相关，L2、L3 BMD与BMI、肌酐成正相关，L4 BMD与BMI成正相关，Torch、Neck、Ward’ s三角、 HtotBMD与BMI、总胆固醇、血钙、磷成正相关，与年龄、病程成负相关（P<0.05)。结论糖尿病男性患者的不同年龄阶段骨密度变化较同龄健康男性不同。其不同部位的骨密度受多种因素的影响，其中BMI、年龄、糖尿病病程为主要影响因素。对于50岁以上的糖尿病男性患者应重视骨密度检测，早期筛查骨质疏松。

英文摘要:

Objective To investigate the characteristics and related factors of bone mineral density (BMD) in men of different ages with type 2 diabetes. Methods A total of 444 male patients diagnosed with type 2 diabetes (T2DM) and 208 healthy men were involved in our study from 2013 to 2014. BMD of the lumbar spine (L1-L4), femoral neck, trochanter, Ward’s triangle and total hip were detected using dual-energy X-ray absorptiometry. The patients with T2DM were divided into 10-year divisions, and BMD between the divisions was compared. The healthy men and patients were also grouped by 5-year division. The BMD between the divisions was compared. The correlation among BMI, duration of diabetes, creatinine (Cr), serum calcium (Ca), serum phosphorus (P)，the levels of TC and TG, and BMD was analyzed. Results (1) The BMD of the Neck and Ward’s triangle was different among T2DM patients of different age (P <0. 05). (2) The BMD of Ward’s triangle between the T2DM patients and healthy males was different in 40-44-year division, but not in 45-59-division. The BMD of LI, L2, Torch, Neck, and the hip was different between the two groups in 60-64-year division. The BMD of LI, L2，L3, L4, Neck, and the hip was different between the two groups in 65-69-year division. (3) In male patients with T2DM, the BMD of LI was positively correlated with BMI, Cr, and Ca, the BMD of L2 and L3 was positively correlated with BMI and Cr, the BMD of L4 was positively correlated with BMI, and the BMD of Torch, Neck, Ward’s triangle, Htot was positively correlated with BMI, TC, Ca, and P, but they were negatively correlated with age and disease duration ( P < 0.05). Conclusion The change of BMD in male T2DM patients is different comparing with that in healthy people at the same age. There are many influential factors, including BMI, age, and disease duration. More attention should be paid to BMD of men over 50 years with T2DM, for the early screening of osteoporosis.

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