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| 2型糖尿病患者骨密度与身体成分关系的研究 |
| The relationship between bone mineral density and body composition in patients with type 2 diabetes |
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| DOI：10.3969/j.issn.1006-7108.2020.02.019 |
| 中文关键词: 2型糖尿病 骨密度 身体成分 |
| 英文关键词:type 2 diabetes bone mineral density body composition |
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| 中文摘要: |
| 目的 分析不同性别中老年2型糖尿病患者骨密度与身体成分的关系。方法 纳入2017年1月至2018年7月在南京医科大学附属常州市第二人民医院内分泌科治疗的657例2型糖尿病患者，年龄50~80岁，其中男性351例，女性306例。记录受试者的糖尿病病程、身高、体重、体质量指数（bone mass index, BMI），检测血脂（TC、TG、HDL、LDL）、糖化血红蛋白（HbA1c）。采用双能X线骨密度仪测定受试者腰椎（L1~4）、股骨颈( Neck)、大转子( Troch)和Ward三角( Wards)的骨密度(bone mineral density, BMD)。采用生物电阻抗法测定体脂率（PBF）、去脂体重（FFM）、肌肉量（SLM）、骨骼肌含量（SMM）及骨骼肌质量指数（SMI），并进行统计学分析。结果 男性2型糖尿病患者的FFM、SLM、SMM、SMI、腰椎L1~4、股骨颈、大转子和Ward三角的BMD均显著高于女性2型糖尿病患者（P<0.001），而体脂率明显低于女性（P<0.001）；按性别分组，男性、女性的BMI、FFM、SLM、SMM、SMI与各部位的BMD均呈显著正相关（P<0.01）。其中，反映骨骼肌肉含量的指标如FFM、SLM、SMM、SMI与BMD的相关性高于反映脂肪含量的指标PBF；多元线性回归显示，骨密度随着年龄增长呈下降趋势。身体成分中，SLM对各部位BMD无明显影响，PBF、FFM、SMM、SMI对各部位BMD的影响不同。结论 骨骼肌肉含量及体脂率对2型糖尿病患者骨密度有重要影响，糖尿病患者需重视体成分对骨质疏松的影响，应加强锻炼，合理控制体脂率。 |
| 英文摘要: |
| Objective To investigate the relationship between bone mineral density and body composition in patients with type 2 diabetes. Methods 657 patients with type 2 diabetes treated in the Changzhou No. 2 People’s Hospital from January 2017 to July 2018 were enrolled in this study. Patients aged 50 to 80 years, including 351 males and 306 females. The duration of diabetes, height, weight, body mass index (BMI), blood lipids (TC, TG, HDL and LDL) and glycosylated hemoglobin (HbA1c) were measured. BMD of the lumbar spine (L1-4), femoral neck, trochanter and Ward’s triangle were measured using dual-energy X-ray absorptiometry. Percent body fat (PBF), Fat free mass (FFM), Soft lean mass (SLM), Skeletal muscle mass (SMM) and Skeletal muscle index (SMI) were measured by Bioelectrical impedance analysis. The above indicators were statistically analyzed. Results Compared with females with type 2 diabetes, males with type 2 diabetes had lower PBF (P <0.001), but higher FFM, SLM, SMM, SMI and BMD at lumbar spine ( L1-4), femoral neck, trochanter and Ward’s triangle (P <0.001). BMD was positively correlated with BMI, FFM, SLM, SMM and SMI both in male group and female group (P <0.01). Indicators reflecting skeletal muscle mass had higher correlation than those reflecting fat content. Multiple linear regression analysis showed that the bone mineral density of different regions decreased with the increase of age, while SLM had no effect on BMD. Body composition index measured including PBF, FFM, SMM and SMI had different influence on BMD. Conclusion Skeletal muscle mass and percent body fat were closely correlated with BMD in patients with type 2 diabetes. Diabetic patients should emphasize the impact of body composition on osteoporosis by doing more exercise and control percent body fat. |
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