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| 老年男性2型糖尿病患者骨密度测定部位的选择及影响因素初探 |
| The proper measurement site of bone mineral density and the related factors in elderly males with type 2 diabetes |
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| DOI：10.3969/j.issn.1006.7108.2018.09.007 |
| 中文关键词: 老年男性2型糖尿病 骨密度测定 影响因素 |
| 英文关键词:elderly male type 2 diabetes measurement of bone mineral densitometry related factors |
| 基金项目:军队十二五课题后勤科研课题面上项目（CWS13J054） |
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| 中文摘要: |
| 目的 比较不同部位骨密度测定对老年男性2型糖尿病患者骨量变化的诊断价值，并探讨影响糖尿病患者骨密度值的相关因素。方法 骨量正常的门诊老年男性2 型糖尿病患者97例，按年龄分成三组，其中60～69岁组共25例，70～79岁组共37例，80岁以上组共35例。比较三组间左侧股骨颈、右侧股骨颈、L1、L2、L3、L4部位的骨密度(Bone mineral density, BMD)及T值差异，找出反映不同年龄组间骨量变化的敏感部位。探讨老年男性2型糖尿病患者的年龄、病程、体重指数(Body mass index, BMI)、合并用药、血钙(Calcium, Ca)、血磷(Phosphorus, P)、碱性磷酸酶(Alkaline phosphatase, ALP)、空腹血糖(Fasting plasma glucose, FPG)、餐后血糖(Postprandial blood glucose, PPG)、糖化血红蛋白(Hemoglobin A1c, HbA1c)、血压(blood pressure, BP)、甘油三酯(Triglyceride, Tg)、总胆固醇(Total cholesterol, Tc)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol, LDL-C)与骨密度值的相关性。使用相关及回归分析判断影响骨密度变化的独立危险因素。结果 1、左侧股骨颈测定的骨密度值及T值在不同年龄组间及每两组之间均存在统计学差异（P<0.05），随年龄增加骨密度值及T值逐渐降低。2、相关分析显示，老年男性2型糖尿病患者的左侧股骨颈骨密度与年龄、糖尿病病程、FPG、PPG、HbA1c、P、ALP、应用噻唑烷二酮类(Thiazolidinediones, TZDs)呈负相关，与BMI呈正相关。回归分析可见，年龄、病程、BMI、HbA1c、使用噻唑烷二酮类是影响老年男性2型糖尿病患者骨密度的独立危险因素。结论 对老年男性2型糖尿病患者，左侧股骨颈部位的骨密度测定能较好的反映骨量随年龄的丢失程度。高龄、低体重、较长的糖尿病病程、较高的HbA1c、使用噻唑烷二酮类药物等可能会增加老年男性2型糖尿病患者的骨量丢失。 |
| 英文摘要: |
| Objective To compare diagnostic value of bone mineral density (BMD) measurement at the different sites in elderly males with type 2 diabetes, and to analyze the related factors. Methods Ninety-seven elderly male patients with type 2 diabetes and normal BMD were selected. They were divided into groups by age, with 25 cases in 60-69 years old group, 37 cases in 70-79 years old group, and 35 cases in over 80 years old group. BMD and T value of the left femoral neck, right femoral neck, lumbar spine (L1, 2, 3, and 4) were compared among different age groups to find out the sensible measurement site of BMD change. The relationship between BMD and age, course of the disease, BMI, drug use, Ca, P, ALP, FPG, PPG, BP, HbA1c, metabolism indexed (Tg, Tc, LDL-C, HDL-C) was explored. Results (1) BMD of the left femoral neck was obvious different among groups (P<0.05), and it decreased along with aging. (2) BMD was negatively correlated with age, course of the disease, HbA1c, TZDs, FBG, PBG, P, and ALP, but was positively correlated with BMI. Logistic regression analysis revealed that age, course of disease, BMI, HbA1c, and TZDs were independent risks of BMD in elderly male patients with type 2 diabetes. Conclusion The left femoral neck can be regarded as the BMD measuring site with vital diagnostic value for elderly male type 2 diabetes. The advanced age, longer course of the disease, higher HbA1c, lower BMI, and TZDs may decrease BMD and increase the risk of osteoporosis in elderly male patients with type 2 diabetes. |
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