摘要
目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血红蛋白水平与骨密度及罹患骨质疏松风险之间的关系。方法采用横断面方法研究2019年9月至2020年9月在南京医科大学附属淮安第一医院内分泌及老年医学科住院的T2DM患者364例。根据双能X线吸收法测定的股骨颈骨密度三分位数水平分为低值组、中值组及高值组。比较3组间一般资料、实验室检查、糖尿病慢性并发症及合并症的差异。多因素logistic回归模型分析血红蛋白水平与骨密度及罹患骨质疏松风险之间的关系,最后根据年龄、体重指数(body mass index,BMI)、糖尿病病程、估算肾小球滤过率(estimated glomeruar filtration rate,eGFR)、糖化血红蛋白(glycosylated hemoglobin,HbA1C)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)、血尿酸(uric acid,UA)进行交互作用和分层分析。结果调整年龄、BMI、糖尿病病程后,血红蛋白水平与绝经后女性骨密度及罹患骨质疏松风险差别无统计学意义(所有P>0.05)。调整年龄、BMI、糖尿病病程、eGFR后,与血红蛋白<130 g/L组相比,血红蛋白≥130 g/L组50岁及以上男性患者,血红蛋白水平与股骨颈骨密度呈正相关(β=0.057,95%CI 0.014~0.100,P=0.011),而与髋部骨密度、腰椎L1-L4骨密度及罹患骨质疏松风险均差异无统计学意义(所有P>0.05)。最后分层分析显示在年龄、BMI、糖尿病病程、eGFR、HbA1C、TC、TG、HDL-C、LDL-C、UA亚组中,交互作用未发现分层变量间差异有统计学意义(所有交互作用P>0.05)。结论50岁及以上男性T2DM患者,高血红蛋白水平可能是股骨颈骨密度的保护因素。
Objective To explore the association of hemoglobin(HGB)levels with bone mineral density(BMD)and osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods A cross-sectional study was conducted in 364 patients with T2DM who were hospitalized in the Department of Endocrinology and Geriatrics of the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University from September 2019 to September 2020.Participants were stratified into tertiles(lower,middle,and upper)according to femoral BMD determined by dual-energy X-ray absorptiometry.Demographic characteristics,medical history,chronic diabetes complications,and comorbid conditions were compared among the 3 groups.The association between hemoglobin levels and BMD/osteoporosis was examined using multivariable logistic regression analyses.Interaction and stratified analyses were conducted according to age,body mass index(BMI),duration of diabetes,estimated glomerular filtration rate(eGFR),glycosylated hemoglobin(HbA1C),total cholesterol(TC),triglycerides(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C)and uric acid(UA).Results After adjusting for age,BMI,and duration of diabetes,there were no significant differences observed in the association between hemoglobin levels and BMD or osteoporosis among postmenopausal women with T2DM(all P>0.05).After adjusting for age,BMI,duration of diabetes,and eGFR,men aged≥50 years with hemoglobin≥130 g/L showed a positive association between hemoglobin level and femoral neck BMD compared to those with hemoglobin<130 g/L(β=0.057,95%CI 0.014-0.100,P=0.011).However,no significant associations were observed between hemoglobin level and BMDs at the total hip or lumbar spine(L1-L4),nor the risk of osteoporosis(all P>0.05).Stratified analyses revealed no significant differences in the subgroups classified based on age,BMI,diabetes duration,eGFR,HbA1C,TC,TG,HDL-C,LDL-C,and UA(all interaction P>0.05).Conclusion In males aged 50 and above with T2DM,elevated hemoglobin levels may be a protective factor for femoral neck bone density.
作者
谭娟
刘媛媛
朱永芳
李红
宋应健
Tan Juan;Liu Yuanyuan;Zhu Yongfang;Li Hong;Song Yingjian(Department of General Practice,the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huaian 223300,China;Department of Endocrinology,the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huaian 223300,China;Department of Health Management Center,the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huaian 223300,China;Department of Respiratory and Critical Care Medicine,the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University,Huaian 223300,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2024年第2期98-103,共6页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金资助项目(82000475)
江苏省老年健康科研面上项目(LKM2022069)。
关键词
血红蛋白
贫血
糖尿病
2型
骨密度
骨质疏松
Hemoglobin
Anemia
Diabetes mellitus,type 2
Bone mineral density
Osteoporosis
