体成分对男性2型糖尿病患者骨密度的影响

目的 应用双能X线骨密度仪（DXA）探讨体成分对男性2型糖尿病患者骨密度的影响。方法 选择年龄50～60岁在我科住院的男性2型糖尿病患者107例，分为正常体重组、超重组和肥胖组，分别测定其身高、体重，计算体重指数（BMI），利用全自动生化分析仪测定血糖、血脂，高压液相色谱法测定糖化血红蛋白（HbA1c），采用双能Ｘ线骨密度仪测定腰椎、左股骨大转子骨密度（BMD）及体成分，并进行统计学分析。结果 3组男性2型糖尿病患者腰椎BMD分别为1.12±0.05，1.21±0.07，1.36±0.09，左股骨大转子BMD分别1.12±0.06，1.22±0.08，1.41±0.08，与骨密度呈正相关；全身各部位肌肉含量与骨密度成正相关，且大腿＞上肢＞躯干；不同部位脂肪含量对骨密度的影响是不同的，其中上肢脂肪和大腿脂肪与骨密度成正相关，而躯干脂肪与骨密度成负相关；年龄、糖化血红蛋白、血脂对男性2型糖尿病患者骨密度无明显影响，而体重指数、肌肉含量及脂肪含量影响明显。结论 体重指数、肌肉含量和脂肪含量对男性2型糖尿病患者骨密度有直接影响。男性2型糖尿病患者加强锻炼，减少腹部脂肪含量，增加四肢肌肉含量，可以预防骨质疏松症的发生。

Effect of body composition on bone mineral density in male patients with type 2 diabetes

Objective To investigate the influence of body composition on bone mineral density of male patients with type 2 diabetes using dual energy X-ray absorptiometry (DXA). Methods One hundred and seven 50-60-year-old male patients with type 2 diabetes in our hospital were selected and divided to normal weight group, overweight group, and obese group. Height and body weight were measured and body mass index (BMI) was calculated. Blood glucose and lipid were determined using a automatic biochemical analyzer. Glycosylated hemoglobin (HbA1c) was measured using a high pressure liquid chromatography. Bone mineral density (BMD) of the lumbar spine and left femoral trochanter, and body composition were measured and statistically analyzed using dual energy X-ray absorptiometry. Results BMD of the lumbar vertebrae in 3 groups was 1.12±0.05, 1.21±0.07, and 1.36±0.09, respectively. BMD of the left femoral greater trochanter was 1.12±0.06, 1.22±0.08, and 1.41±0.08, respectively. The muscle mass of various parts of the body was positively correlated with BMD, and the thigh was greater than the upper limb and the upper limb was greater than the trunk. Effect of fat content on BMD was different in different parts of the body. The fat of the upper limb and thigh was positively correlated with BMD, but the fat of trunk was negatively correlated with BMD. Age, glycosylated hemoglobin, and blood lipids had no effect on BMD in male patients with type 2 diabetes. However, BMI, muscle mass, and fat content had significant effect on BMD. Conclusion BMI, muscle mass, and fat content have a direct impact on BMD in male patients with type 2 diabetes. Male patients with type 2 diabetes should do exercise, reduce abdominal fat content, and increase the content of the limb muscles to prevent the occurrence of osteoporosis.