摘要
目的观察住院新诊断2型糖尿病(T2DM)患者骨密度(BMD)改变情况并探讨其影响因素。方法选择北京大学人民医院新诊断T2DM患者111例(男性75例,女性36例),采用双能X线骨密度仪测定患者腰椎、股骨颈及全髋BMD,按T值不同分为2个亚组:骨量正常组(T值>-1.0SD);骨量减少组(-2.5 SD<T值≤-1.0 SD);比较两组之间各种生化指标及BMD的差异并进行相关性分析。结果 1、骨量减少组的年龄大于骨量正常组(P<0.05),而体重及体重指数(BMI)低于后者(P分别<0.05及<0.01)。骨量减少组的稳态模型胰岛素抵抗指数取自然对数值(Ln(HOMA-IR))稍低于骨量正常组,而游离三碘甲状腺原氨酸(FT3)高于后者,差异有统计学意义(P均<0.05)。骨量减少组合并脂肪肝的比例为51.2%,明显低于骨量正常组合并脂肪肝的比例71.9%,差异有统计学意义(P<0.05)。2、骨量减少组的腰椎、股骨颈及全髋BMD均明显低于骨量正常组(P均<0.01)。3、Pearson相关分析显示,腰椎骨密度与舒张压负相关(P<0.05),与体重、空腹血糖(FBG)、Ln(HOMA-IR)正相关(P均<0.01)。股骨颈及全髋骨密度均与年龄和高密度脂蛋白胆固醇(HDL-C)负相关,与体重、腰围、BMI及尿酸正相关(P均<0.01)。在校正年龄、体重及BMI等影响因素后,股骨颈骨密度与HDL-C负相关(r=-0.269,P=0.028)。结论新诊断T2DM患者的骨密度除了与年龄及体重有关外,升高的HDL-C水平可能与骨密度降低有一定的关系。
Objective To investigate the change of bone mineral density（ BMD） and its influential factors in patients with newly diagnosed type 2 diabetes（ T2DM）.Me thods One hundred and eleven patients with newly diagnosed T2 DMwere selected,including 75 males and 36 females.BMD of the lumbar vertebrae,femoral neck,and total hip was measured using dual energy Xray absorptiometry（ DEXA）.The patients were divided into 2 subgroups according to T score,normal BMD group（ T -1.0SD） and osteopenia group（-2.5 SD T≤-1.0 SD）.The differences of biochemical indexes and BMD between the two groups were compared.Re sults 1） Age was significantly older,and weight and BMI were lower in osteopenia group than those in normal BMD group（ P〈0.05）.Ln（ HOMA-IR） in osteopenia group was slightly lower than that in normal BMD group（ P〈0.05）.Free triiodothyronine（ FT3） in osteopenia group was significantly higher than that in normal BMD group（ P〈0.05）.The incidence of fatty liver in osteopenia group（ 51.2%） was significantly lower than that in normal BMD group（ 71.9%,P〈0.05）.2） BMD of the lumbar vertebrae,femoral neck,and total hip was significantly lower in osteopenia group than that in normal BMD group（ P〈0.01）.3） Correlation analysis showed that BMD of the lumbar vertebrae was negatively correlated with diastolic pressure（ P〈0.05）,but was positively correlated with weight,FBG and Ln（ HOMA-IR,P〈0.01）.BMD of the femoral neck and total hip was negatively correlated with age and HDL-C,but was positively correlated with weight,waist,BMI and the serum uric acid（ P〈0.01）.After adjustment for age,weight and BMI,HDL-C was negatively correlated with the BMD of the femoral neck（ r =-0.269,P = 0.028）.Conclusion Besides BMD is associated with age and body weight,increased HDL-C may be associated with decreased BMD in newly diagnosed type 2 diabetes.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2016年第3期321-325,共5页
Chinese Journal of Osteoporosis
关键词
2型糖尿病
骨密度
骨质疏松
Type 2 diabetes
Bone mineral density
Osteoporosis
