中老年男性及绝经后女性2型糖尿病患者SUA/CR与BMD、BTMs的相关性
The relationship between SUA/CR and BMD, BTMs in middle-aged and elderly males and postmenopausal females with T2DM
  
DOI:10.3969/j.issn.1006-7108.2022.12.015
中文关键词:  2型糖尿病  血尿酸肌酐比  骨密度  骨代谢标志物  骨质疏松
英文关键词:type 2 diabetes mellitus  serum uric acid to creatinine ratio  bone mineral density  bone metabolic markers  osteoporosis
基金项目:合肥市卫生健康委应用医学研究项目(2019NO.43)
作者单位
朱彰祥 江旭 叶启宝 陈丽 王国娟 安徽医科大学第三附属医院(合肥市第一人民医院滨湖院区)内分泌科 
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中文摘要:
      目的 回顾性研究中老年男性及绝经后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者血尿酸肌酐比(SUA/CR)与骨代谢标志物及骨密度(bone mineral density,BMD)的关系。方法 纳入在我院住院的T2DM 患者668例,将中老年男性依据SUA/CR水平进行三分位分组,依次分为M1组、M2组、M3组;绝经后女性依据SUA/CR水平进行三分位分组依次分为F1组、F2组、F3组。结果 ①中老年男性与绝经后女性SUA/CR水平越高,骨质疏松(osteoporosis,OP)或骨量减少比例越低;②中老年男性中,M1组股骨颈BMD最低,1型胶原C端交联肽(CTX)、骨钙素(N-OC)最高(P<0.05);绝经后女性中,F3组患者大转子、股骨颈、腰椎1~4(L1~4)、Ward’s三角BMD最高;F1组N-OC、CTX最高(P<0.05);③中老年男性SUA/CR与股骨颈BMD正相关,与N-OC、CTX、总1型胶原N端延长肽(P1NP)负相关(P<0.05);绝经后女性SUA/CR与L1~4、股骨颈、大转子、Ward’s三角BMD及VD正相关,与N-OC、P1NP、CTX负相关(P<0.05);④Logistic回归分析显示SUA/CR是OP或骨量减少的保护性因素。结论 高水平SUA/CR是中老年男性及绝经后女性T2DM患者OP及骨量减少的保护性因素。
英文摘要:
      Objective A retrospective research was designed to analyze the relationship between serum uric acid to creatinine ratio (SUA/CR) and bone turnover markers, bone mineral density (BMD) in middle-aging males and postmenopausal females with type 2 diabetes mellitus (T2DM). Methods We recruited 333 male and 335 female patients with T2DM and assigned them into 3 groups according to the level of SUA/CR respectively. Males were divided into M1, M2, and M3 group. Females were divided into F1, F2, and F3 group. Results (1) The higher the SUA/CR levels, the lower the proportion of osteoporosis or osteopenia presented in middle-aging males and postmenopausal females. (2) In middle-aging males, BMD of the femoral neck was the lowest in M1 group, and n-mid osteocalcin (N-OC) and c-terminal crosslinking peptide of type 1 collagen (CTX) were the highest in M1 group (P < 0.05). In postmenopausal females, the BMD of lumbar 1-4, femoral neck, Ward's triangle and great trochanter were the highest in F3 group (P < 0.05). The highest levels of N-OC and CTX levels were in F2 group (P < 0.05). (3) Pearson correlation analyses revealed that SUA/CR was significantly and positively associated with BMD of the femoral neck and negatively associated with N-OC, CTX, and P1NP in middle-aging male patients (P < 0.05). SUA/CR was significantly and positively associated with BMD and VD of the femoral neck, lumbar L1-4, Ward's triangle, and great trochanter and negatively associated with N-OC, CTX, and P1NP in postmenopausal patients. (4) Logistic regression analysis indicated that SUA/CR was a protective factor for osteoporosis and osteopenia in middle-aging males and postmenopausal patients with T2DM. Conclusion High SUA/CR level is a protective factor for osteoporosis and osteopenia in middle-aging males and postmenopausal females with T2DM.
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