摘要
目的探讨与老年男性2型糖尿病(type 2 diabetes mellitus,T2DM)骨质疏松(osteoporosis,OP)发生相关的因素。方法选取老年男性T2DM患者288例,根据OP诊断标准分为骨量正常组(72例)、骨量减少组(118例)和骨质疏松组(98例)。测量身高、体重,计算体质指数(body mass index,BMI);测定空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、甲状旁腺素(parathyroid hormone,PTH)、血清钙(serum calcium,Ca)、血清磷(serum phosphonium,P)、25羟维生素D(serum 25-hydroxyvitamin D,25-OH-VD)及尿白蛋白/肌酐(urinary albumin/creatinine ratio,ACR),记录患者病程、降糖药物使用和糖尿病慢性并发症情况。结果与骨量正常组比较,骨质疏松组和骨量减少组病程较长和HbA1c较高,BMI减低,差异均有统计学意义(均有P<0.05)。相关分析显示股骨颈、三角区、大转子、腰椎(lumbar vertebrae,L)2-4节骨密度(bone mineral density,BMD)与BMI均呈正相关(均有P<0.05),但与HbA1C均呈负相关(均有P<0.05)。骨质疏松组糖尿病肾病、糖尿病视网膜病变发生率均高于骨量正常组、骨量减少组(均有P<0.05);骨质疏松组糖尿病神经病变发生率高于骨量正常组(X^2=6.168,P=0.013)。Logistic回归分析显示BMI、HbA1c及糖尿病肾病与糖尿病骨质疏松发生相关(均有P<0.05)。结论低BMI,血糖控制不佳和糖尿病肾病是老年男性T2DM患者OP发生的危险因素。
Objective To explore the related factors for osteoporosis（OP） among elderly male patients with type 2 diabetes （T2DM）. Methods A total of 288 elderly male patients with T2DM were divided into 3 groups according to the diagnosis standards of OP ： normal group （ n = 72 ）, ostepenia group （ n = 118 ） and osteoporosis group （ n = 98 ）. Body height, weight were measured and body mass index（BMI） was calculated. Fasting blood glucose（FBG） , glycosylated hemoglabinA 1 c （ HbA 1 c ） , parathyroid hormone （FFH） , serum calcium （Ca） , serum phosphonium （P） , serum 25-hydroxyvitamin D（25-OH-VD） and urinary albumin/creatinine ratio（ACR） were detected. Diabetic course, diabetes specific therapy and diabetic chronic complications were recorded. Results Compared with normal group, ostepenia and osteoporosis groups had longer diabetic course, higher HbA1 c levels, and lower BMI （all P 〈 0. 05 ）. Correlation analysis showed that bone mineral density（BMD） value of femoral neck, Ward~ triangle region, greater troehanter and lumbar spine L2-4 were positively correlated with BMI （ all P 〈 0. 05 ）, but negatively correlated with HbA1 c （ all P 〈 0. 05 ）. The incidences of diabetic nephropathy, diabetic retinopathy were higher in osteoporosis group than in normal and ostepenia groups （ all P 〈 0. 05 ） , and the incidence of diabetic neuropathy was higher in osteoporosis group than in normal group （ x2 = 6. 168, P = 0. 013 ）. Logistic regression analysis showed that BMI, HbAI c and diabetic nephropathy were correlated with diabetetic osteoporosis （ all P 〈 0. 05 ）. Conclusions Low BMI, poor blood glucose control and diabetic nephropathy were the risk factors for OP in elderly male patients with T2DM.
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2017年第7期688-692,共5页
Chinese Journal of Disease Control & Prevention
基金
安徽省年度重点科研项目(11070403035)
关键词
糖尿病
2型
骨质疏松
危险因素
Diabetes melfitus, type 2
Osteoporosis
Risk factors
作者简介
麻红艳（1982-），女，安徽六安人，主治医师，在读硕士研究生。主要研究方向：糖尿病与骨质疏松研究。
叶山东，E-mail：ysdl96406@163．com
