甘肃地区2型糖尿病患者骨密度变化及影响因素

目的研究甘肃地区2型糖尿病患者的骨密度变化及其影响因素。方法采用双能X线骨密度仪对206例2型糖尿病患者(糖尿病组)和2433例非糖尿病被调查者(对照组)进行左前臂和右足跟的骨密度测定。对两组人群的骨密度变化进行t检验,并对年龄、体质量指数、血压、胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、血尿酸、糖化血红蛋白、维生素D、血钙、血磷进行Pearson相关分析,将存在相关性的因素进行多元逐步回归分析,得出主要危险因素。结果糖尿病组中左前臂诊断为骨质疏松症者为83例(40. 29%),右足跟为74例(35. 92%);对照组中左前臂诊断为骨质疏松症者为454例(18. 66%),右足跟为529例(21. 74%)。糖尿病组左前臂和右足跟骨密度得测定值均明显低于对照组,差异具有统计学意义(P 0. 05)。2型糖尿病患者左前臂骨密度改变与收缩压、高密度脂蛋白、血磷、年龄呈负相关,与血尿酸、维生素D呈正相关;右足跟骨密度改变与高密度脂蛋白、血磷、年龄呈负相关,与血尿酸呈正相关。结论 2型糖尿病患者的左前臂骨密度值减低,且其影响因素较多,若对其影响因素在临床治疗时对上述影响因素实施积极有针对性的干预,对降低2型糖尿病患者骨质疏松的发生率以及维护其健康具有一定的临床意义。

Changes of bone mineral density and its influential factors in type 2 diabetic patients in Gansu province

Objective To study the changes of bone mineral density (BMD) and its influential factors in patients with type 2 diabetes in Gansu province. Methods BMD of the left forearm and right heel was measured in 206 patients with type 2 diabetes (diabetic group) and 2433 non-diabetic subjects (control group) using dual energy X-ray absorptiometry. The t-test was performed on the changes in BMD in the two groups. Age, body mass index, blood pressure, cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, blood uric acid, glycosylated hemoglobin, vitamin D, blood calcium, and blood phosphorus were collected and analyzed using Pearson correlation analysis. Multivariate stepwise regression analysis was performed to determine the main risk factors. Results In the diabetic group, 83 cases (40.29%) were diagnosed as osteoporosis in the left forearm and 74 cases (35.92%) in the right heel. In the control group, 454 cases (18.66%) were diagnosed as osteoporosis in the left forearm and 529 cases (21.74%) in the right heel. The measured values of BMD in the left forearm and right heel of the diabetic group were both significantly lower than those in the control group (P < 0.05). The change of left forearm BMD in patients with type 2 diabetes was negatively correlated with systolic blood pressure, high-density lipoprotein, serum phosphorus, age, but was positively correlated with serum uric acid and vitamin D. The change of right heel BMD was negatively associated with high-density lipoprotein, serum phosphorus, age, but was positively correlated with blood uric acid. Conclusion The left forearm BMD reduces in patients with type 2 diabetes. Many influential factors exist. If the above-mentioned influential factors that implement in the clinical treatment can be actively intervened, the occurrence of osteoporosis may reduce and the health may maintain in patients with type 2 diabetes.