|
| 男性T2DM患者胰岛素抵抗与骨量关系初探 |
| The study of correlation between insulin resistance and bone mass in male patients with T2DM |
| |
| DOI：10.3969/j.issn.1006-7108.2018.12.015 |
| 中文关键词: 胰岛素抵抗 骨密度 体重标准化骨矿含量 相关性 |
| 英文关键词:insulin resistance bone mineral density corrected bone mineral content by weight correlation |
| 基金项目:四川省科技支撑计划项目 （2011SZ0088） |
|
| 摘要点击次数: 1072 |
| 全文下载次数: 509 |
| 中文摘要: |
| 目的 研究男性T2DM患者胰岛素抵抗与骨量间的相关性，为糖尿病合并骨质疏松症的病因学研究提供新思路。方法 选取2016年3月至9月在成都中医药大学附属医院内分泌科住院男性T2DM患者260例，收集临床一般资料、生化核医学指标、第1至第4腰椎椎体和左侧股骨颈的骨密度及体重标准化骨矿含量等资料进行组间比较，以HOMA-IR四分位分为4组，分别以50岁及病程4年为界进行分层，对HOMA-IR和cBMC、aBMD进行双变量相关性分析。结果 ①各组的体重、BMI、SBP、TG均随HOMA-IR上升呈递增趋势，而HDL-c随之逐渐下降，组间差异有统计学意义；②各组的血清磷、碱性磷酸酶、白蛋白、钙、CYS-C、TC和LDL-c及eGFR等结果，均差异无明显统计学意义 (P＞0.05)；③HOMA-IR与FN的aBMD呈正相关(r=0.17,P＜0.01)，进行年龄分层后，在≤50y组中差异仍有统计学意义(r=0.226,P=0.021)，根据病程分层，亦只在FN的≤4y组中差异有统计学意义(r=0.208，P=0.016)，余皆无明显相关性(P＞0.05)；④HOMA-IR与＞50y组L2的cBMC(r=–0.189)、两个年龄组L3、L4的cBMC(r =–0.251, –0.228, –0.202, –0.165)皆呈负相关(P＜0.05)；根据病程分层，只与L1-L4的＞4y组的cBMC负相关(r=–0.204，–0.242，–0.296，–0.241)(P＜0.05)，余差异皆无统计学意义。结论 男性T2DM患者中，HOMA-IR与FN的骨密度正相关，与腰椎骨强度负相关，单从aBMD评估骨折风险是不够的，cBMC是一个可以考虑采用的指标。 |
| 英文摘要: |
| Objective To observe the relationship between insulin resistance and bone mass in male patients with T2DM, and to provide new idea for the etiology of diabetes mellitus combined with osteoporosis. Methods A total of 260 male T2DM patients were selected from the Department of Endocrinology, Teaching Hospital of Chengdu University of TCM, between March and September 2016. General clinical data, biochemical and nuclear medicine data, bone mineral density of the lumbar vertebrae (L1-4) and the left femoral neck, and corrected bone mineral content?by weight were collected and compared. The patients were divided into 4 groups according to HOMA-IR, and further stratified by 50 years of age and 4-year time course of the disease. HOMA-IR, cBMC, and aBMD were analyzed with bivariate correlation analysis. Results ①The weight, BMI, SBP, and TG increased with the increase of HOMA-IR, while HDL-c decreased successively, and the differences among the groups were statistically significant. ②There was no significant difference in serum phosphorus, alkaline phosphatase, albumin, calcium, CYS-C, TC, LDL-c, and eGFR among the groups (P>0.05). ③aBMD of the femoral neck was positive correlated with HOMA-IR (r=0.17, P<0.01). After?age stratification, there was still significant difference in ≤50y group (r =0.226, P =0.021) and in ≤4y group (r=0.208, P=0.016) after stratified with course of disease, but no correlation in other groups. ④HOMA-IR was negatively correlated with cBMC of L2 in > 50y group (r =–0.189) and cBMC of the L3 and L4 in the two age groups (r =–0.251, –0.228, –0.202, –0.165, P< 0.05). After stratified with course of disease, HOMA-IR was only negatively correlated with cBMC of L1-L4 in the > 4y group (r=–0.204, –0.242, –0.296, –0.241, P < 0.05). Conclusion HOMA-IR is positively correlated with BMD of the femoral neck, but negatively correlated with bone strength of the lumbar spine. aBMD alone is not enough to assess fracture risk in male T2DM patients. cBMC is a parameter that can be applied. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|