中国骨质疏松杂志

新型炎症标志物与2型糖尿病骨质疏松风险相关性分析

Correlation analysis between novel inflammatory markers and osteoporosis risk in patients with type 2 diabetes

DOI：10.3969/j.issn.1006-7108.2025.05.006

英文关键词:osteoporosis type 2 diabetes pan-immune-inflammation value immune-inflammation index

基金项目:湖南省自然科学基金（2023JJ60068）；湖南省卫生健康委课题（D202303066791）；临床医疗技术创新引导项目（2021SK53111）

作者	单位
赵晋晋皮银珍* 龚海燕高海花	长沙市第一医院内分泌代谢科，湖南长沙 410005

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中文摘要:

目的分析泛免疫炎症值（PIV）及全身免疫炎症指数（SII）与2型糖尿病（type 2 diabetes，T2DM）患者发生骨质疏松风险的相关性。方法选取2021年1月至2022年6月长沙市第一医院收治的T2DM患者411例，根据骨密度分为骨质疏松组（206例），非骨质疏松组（205例），收集受试者一般资料及临床指标，计算PIV、SII，进行相关统计学分析。结果相较于非骨质疏松组，骨质疏松组女性患者占比更多，体质量指数（body mass index, BMI)更低，骨代谢指标OC、β-CTX更高，各部位骨密度均显著下降，PIV、SII显著升高（P<0.05）。偏相关分析显示，SII、PIV与骨形成指标OC、股骨颈骨密度（FN-BMD）及全髋骨密度（TF-BMD）呈负相关，与骨质疏松发病风险呈正相关。二元Logistics回归分析提示校正相关混杂因素包括年龄、性别、BMI、病程、Cr、ALT、AST、HbA1C、Ca、25(OH)D、吸烟史、饮酒史、既往用药史、合并症后，PIV（OR=1.66，95% CI：1.18 ~2.35，P=0.004）、SII（OR=1.97，95% CI：1.29~3.01，P=0.006）为骨质疏松发生的独立危险因素，PIV、SII第四分位数患者发生骨质疏松的风险分别是第一分位数的2.44倍和2.81倍；亚组分析提示在≥65岁及BMI< 24 kg/m2的2型糖尿病人群中，PIV、SII与骨质疏松发生风险的相关性显著。限制性立方样条图显示PIV、SII与发生骨质疏松风险呈线性正相关，与股骨颈骨密度（FN- BMD）、全髋骨密度（TH-BMD）呈线性负相关（总体P<0.05，非线性P>0.05）。结论 PIV、SII是T2DM患者发生骨质疏松的独立危险因素，具有高水平PIV、SII的T2DM患者需警惕骨质疏松发生的潜在风险。

英文摘要:

Objective To investigate the association between PIV and SII with the risk of osteoporosis in patients with T2DM. Methods A total of 411 T2DM inpatients from January 2021 to June 2022 in the First Hosptial of Changsha were included in our study. They were divided into osteoporosis group (n=206) and non-osteoporosis group (n=205) based on bone mineral density. The general data and clinical indicators of the patients were collected. PIV and SII were calculated. All the data were statistical analysis further. Results The proportion of female patients in the osteoporosis group was higher, BMI was lower, and OC and β-CTX were higher than in the non-osteoporosis group. A significant decrease was found in bone mineral density, but PIV and SII increased significantly (P<0.05). Partial correlation analysis showed that SII and PIV were negatively correlated with OC, FN-BMD, and TF-BMD, but were positively correlated with the presence of osteoporosis. Binary logistic regression analysis suggested that after adjusting for age, gender, BMI, disease duration, Cr, ALT, AST, HbA1C, Ca, 25 (OH) D, smoking history, alcohol consumption history, previous medication history, complications, PIV (OR= 1.66, 95% CI: 1.18-2.35, P=0.004), and SII (OR=1.97, 95% CI:1.29-3.01, P=0.006) were independent risk factors for osteoporosis in type 2 diabetes patients. The risk of osteoporosis in the fourth quantile of PIV and SII group was 2.44 times and 2.81 times higher than in the first quantile group, respectively. Subgroup analysis showed that the association among PIV, SII, and the risk of osteoporosis were pronounced in those with T2DM aged over 65 years old or in those with BMI less than 24 kg/m2. Restricted cubic spline analysis indicated that PIV and SII were linearly positively correlated with the risk of osteoporosis, and were linearly negatively correlated with FN-BMD and TH- BMD (overall P<0.05, non-linear P>0.05). Conclusion PIV and SII are independent risk factors for osteoporosis in T2DM patients. Moreover, T2DM with a high level of PIV and SII should be aware of the potential risk of osteoporosis.

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