老年2型糖尿病骨质疏松相关因素分析

目的分析2型糖尿病(T2DM)患者合并骨质疏松的骨密度(BMD)的改变与部分临床检查指标的相关性,为预防、诊断和治疗T2DM合并骨质疏松提供理论依据。方法选取本院72名已确诊的T2DM住院患者。空腹血检测糖化血红蛋白、血糖、血钙、磷、生化及双能X线骨密度测定。根据T2DM患者的BMD值,将其分为骨质疏松组和非骨质疏松组,对比两组患者的性别、年龄、病程、体重指数(BMI)、空腹血糖(FPG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血清钙、血清磷、糖化血红蛋白(HbA1c)等指标间的差异,并进行相关性分析。结果根据WHO诊断标准,本组病例中骨质疏松患者达到44.4%。骨质疏松(OP)组与非OP组比较,OP组年龄显著大于非骨质疏松组,病程明显长于非骨质疏松组,BMI显著低于非骨质疏松组。两组实验室指标中空腹血糖(FPG)糖化血红蛋白(HbA1c)、血钙、血磷及高密度脂蛋白(HDL)无显著差异;OP组总胆固醇(TC)、低密度脂蛋白(LDL)高于非OP组。相关性分析显示BMD与BMI及血清钙呈正相关,而与年龄、病程、TC、LDL呈负相关,与血磷、FPG、HbA1c及HDL无明显相关性;此外男女性别间BMD存在显著差异,老年女性BMD低于老年男性。结论年龄是T2DM患者并发骨质疏松的重要危险因素,而高BMI能对骨质起相对保护作用;糖、脂代谢紊乱对骨密度的影响需引起重视;此外老年女性更应注意骨质疏松风险。

Analysis of osteoporosis related factors in the elderly with type 2 diabetes

Objective To analysis the correlation between bone mineral density (BMD) and the serum biochemical index in patients with type 2 diabetes (T2DM) and osteoporosis, in order to provide theoretical evidence for the prevention, diagnosis, and treatment of osteoporosis. Methods A total of 72 elderly patients with T2DM were randomly selected in our hospital. Fasting blood sample were collected to determine glycosylated hemoglobin, blood sugar, blood biochemical parameters, calcium, and phosphorus. BMD was determined using dual energy X-ray absorptiometry. According to the BMD value, the patients were divided into osteoporosis group and non-osteoporosis group. Gender, age, disease time course, BMI, FPG, TC, HDL, LDL, serum calcium and phosphorus, and HbA1c were compared between the 2 groups. The correlation study was conducted. Results According to the WHO criteria, in this study patients with osteoporosis were up to 44.4%. The age of patients in osteoporosis group was significantly lower, the course of disease was significantly longer, and the BMI was significantly lower than those in non-osteoporosis group. FPG, HbA1c, serum calcium and phosphorus, and HDL were not statistically different between the 2 groups. TC and LDL in osteoporosis group were higher than those in non-osteoporosis group. Correlation analysis indicated that BMD was positively correlated with BMI and calcium, but negatively correlated with age, course of disease, TC, and LDL. Phosphorus, FPG, HbA1c, and HDL were not correlated with BMD. In addition, BMD of older women was significantly lower than that of older men. Conclusion Age is the important risk factor of osteoporosis, but higher BMI is a protective factor in T2DM patients. We should pay attention to the effect of metabolic disorder of lipid and glucose on bone mineral density. Old women should pay more attention to the risk of osteoporosis.