摘要
目的观察不同骨量状态的2型糖尿病(T2DM)患者的糖脂代谢、骨代谢生化指标水平,探讨T2DM患者的骨质疏松(OP)相关危险因素。方法选择北京大学人民医院T2DM患者264例(男性133例,女性131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3个亚组:骨密度正常组(T值>-1.0);骨量减少组(-2.5<T值≤-1.0);OP组(T值≤-2.5)。比较3组之间各种生化、骨代谢指标及BMD的差异并进行相关性分析。结果 1OP组的年龄明显大于其余两组,体重及血尿酸水平明显低于其余两组(P均<0.05)。2OP组的血清BALP及TRACP-5b水平明显高于其余两组(P均<0.05)。OP组和骨量减少组的L1-4、股骨颈及全髋BMD均明显低于正常组,尤以OP组下降明显(P均<0.05)。3男性T2DM患者中,OP组的血尿酸明显低于其余两组,而血清TRACP-5b明显高于其余两组(P均<0.05)。女性T2DM患者中,OP组的血清BALP明显高于其余两组(P<0.05)。4在校正性别、年龄及体重等因素影响后,腰椎骨密度与尿酸正相关(r=0.137,P<0.05),与BALP、TRACP-5b负相关(r=-0.281,-0.146,P均<0.05)。股骨颈骨密度与舒张压、BALP、TRACP-5b负相关(r=-0.135,-0.237,-0.136,P均<0.05),全髋骨密度与BALP负相关(r=-0.25,P<0.05)。5Logistic回归分析结果显示:T2DM患者的年龄、BALP、低体重、低血尿酸水平与OP发生有关(P<0.05)。结论年龄、BALP、低体重、低血尿酸水平与T2DM患者发生OP有关。
Obje ctive To study the levels of biochemical index and bone metabolism biochemical markers in patients with type 2diabetes mellitus（ T2DM）,to analyze their associations with bone mineral density（ BMD） and to discuss risk factors for osteoporosis（ OP） in T2 DMpatients. Me thods Two hundred and sixty-four patients with T2 DMwere selected,including 133 male cases and 131 female cases. Diabetic patients were divided into 3 subgroups according to BMD T-score,normal BMD group：T-score 〉- 1. 0; osteopenia group：- 2. 5 〈 T score≤- 1. 0; osteoporosis group： T-score ≤- 2. 5. Biochemical index and bone metabolism biochemical markers were measured. BMD was determined by using dual-energy X-ray absorptiometry（ DXA）.Re sults Body weight and serum uric acid in osteoporosis group were significantly lower than those in the normal BMD group and osteopenia group（ all P 〈 0. 05）. Serum BALP and TRACP-5b in the osteoporosis group were significantly higher than those in the other two groups（ P 〈 0. 05）. Compared with the normal BMD group,BMD of lumbar vertebrae,femoral neck and total hip in osteoporosis group and osteopenia group were significantly lower（ all P 〈 0. 05）. In male T2 DMpatients,serum TRACP-5b in osteoporosis group was significantly higher than that in the normal BMD group and osteopenia group（ P 〈 0. 05）,while serum uric acid in the osteoporosis group was lower than that in the latter. In female T2 DMpatients,serum BALP in the osteoporosis group was significantly higher than that in the other two groups（ P 〈 0. 05）. After adjustment for age,sex,BMI and weight,BMD of lumbar vertebrae positively correlated with uric acid（ r = 0. 137,P 〈 0. 05）,but negatively correlated with BALP,TRACP-5b（ r =- 0. 281,- 0. 146,all P 〈 0. 05）. The BMD of femoral neck negatively correlated with diastolic pressure,BALP and TRACP-5b（ r =-- 0. 135,- 0. 237,- 0. 136,all P 〈 0. 05）. The BMD of total hip negatively correlated with BALP（ r =- 0. 25,P 〈0. 05）. Logistic regression analysis showthat age,BALP,lowweight and lowserum uric acid were correlated with the incidence of OP in T2 DMpatients（ P 〈 0. 05）. Conclusion Age,BALP,lowbody weight and lowserum uric acid were risk factors for OP in T2 DMpatients.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2016年第10期1283-1287,1297,共6页
Chinese Journal of Osteoporosis
关键词
骨质疏松症
2型糖尿病
骨代谢生化指标
Osteoporosis
Type 2 diabetes
Bone metabolism biochemical markers
