中老年2型糖尿病患者骨密度水平与代谢指标及并发症相关性分析
Correlation analysis of bone mineral density, metabolic index and complications in middle-aged and older type 2 diabetes mellitus patients
  
DOI:10.3969/j.issn.1006-7108.2019.10.011
中文关键词:  2型糖尿病  骨密度  骨质疏松  中老年
英文关键词:type 2 diabetes mellitus  bone mineral density  osteoporosis  middle-aged
基金项目:
作者单位
袁琴 吴加华 宋微笑 张楠* 浙江大学医学院附属邵逸夫医院内分泌科浙江 杭州 310020 
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中文摘要:
      目的 探讨中老年2型糖尿病(type 2 diabetic mellitus,T2DM)患者腰椎骨密度(bone mineral density,BMD)与代谢指标及糖尿病并发症的关系。方法 回顾性分析228例中老年T2DM患者的住院资料,按腰椎1~4(L1-L4)BMD的水平分为骨量正常组(T>-1.0SD)、骨量减少组(-2.5 SD<T≤-1.0 SD)及骨质疏松组(T≤-2.5 SD),比较各组临床资料、血糖控制、代谢指标、糖尿病并发症情况,并分析腰椎BMD与各指标的相关性。结果 (1)随骨密度下降,体质量指数(body mass index,BMI)下降,女性比例、感觉阈值(vibration perception threshold,VPT)增加,差异有统计学意义(P<0.01);骨质疏松组年龄、糖化血清白蛋白(glycated albumin,GA)大于骨量正常及骨量减少组(P<0.01),且发生糖尿病足病明显增加(P<0.05);骨质疏松组病程、空腹及餐后2 h血糖大于骨量减少组(P<0.05),腰围、尿酸、甘油三酯低于骨量正常组(P<0.01),高密度脂蛋白胆固醇(HDL-C)、血镁高于骨量正常组(P<0.05);骨量减少组碱性磷酸酶高于骨量正常组(P<0.05),腰围(P<0.05)、尿酸(P<0.01)、总胆固醇(P<0.05)低于骨量正常组。(2)相关分析提示,腰椎BMD与年龄、性别(女)、GA、HDL-C、血镁、VPT(异常)呈负相关(P<0.05);与腰围、BMI、尿酸、甘油三酯呈正相关(P<0.01)。(3)以腰椎骨密度为因变量,进一步行多重线性回归分析,结果显示BMI、性别(女)、VPT(异常)、尿酸差异有统计学意义。结论 女性患者和感觉阈值异常是T2DM患者骨密度降低的独立危险因素,而适当高BMI及高尿酸则是骨密度降低的保护因素。
英文摘要:
      Objective To explore the relationship between bone mineral density (BMD) of lumbar vertebrae, metabolic index and diabetic complications in middle-aged and older patients with type 2 diabetes mellitus (T2DM). Methods 228 middle-aged and older T2DM patients were enrolled in this retrospective study and were divided into 3 groups according to BMD of lumbar vertebrae 1-4 (L1-L4): normal BMD group (T>-1.0 SD), osteopenia group (-2.5 SD
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