老年男性2型糖尿病患者骨密度及相关因素分析

目的 探讨老年男性2型糖尿病患者骨质疏松发病的危险因素. 方法 应用双能X线骨密度仪测定80例老年男性2型糖尿病患者的腰椎和股骨骨密度.并检测血清和尿液中骨代谢及血糖相关的生化指标,分析影响患者骨密度的相关危险因素. 结果所有患者中依据任一部位的骨密度值,骨质疏松的检出率为18.6%,骨量减少的检出率为53.8%.体质量和体质量指数(BMI)与腰椎、股骨颈和Ward's三角的骨密度呈正相关(r=0.202～0.298,P<0.05或P<0.01),年龄、糖化血红蛋白(HbAlc)与腰椎和股骨颈的骨密度呈负相关(r=-0.172～-0.211,均P<0.05).瘦素除与股骨颈和Ward's三角骨密度呈正相关外,尚与体质量、BMI、空腹血糖、血清总胆固醇、HbAlc相关(r=0.219～0.509,P<0.05或P<0.01).多元逐步回归分析显示,体质量是所有部位骨密度的影响因素,HbAlc影响股骨颈骨密度,瘦素影响Ward's三角区骨密度(r~2=0.196～0.276,均P<0.01). 结论 老年男性2型糖尿病患者中,不同部位的骨密度受不同的因素影响.

Clinic analysis of bone mineral density and its related factors in elderly men with type 2 diabetes

Objective To explore the possible risk factors that influence bone mineral density (BMD) in elderly men with type 2 diabetes. Methods A total of 80 elderly men with type 2 diabetes were included in this study. The BMD of lumbar vertebrae and femur were measured by dual-energy X-ray absorptiometry (DXA). And fasting blood and urine samples were taken to check the biochemical levels of bone metabolism and blood glucose. The correlations between BMD and other related factors were analyzed. Results In this group, the prevalence rates of osteoporosis and osteopenia were 18. 6% and 53.8%, respectively. Body mass and body mass index (BMI) were positively correlated with BMD at all sites (r=0. 202～0. 298, P<0. 05 or P<0. 01). However, age and glycosylated hemoglobin (HbAlc) were negatively correlated with BMD of lumbar and femoral neck (r=-0. 172～-0. 211 ,all P<0. 05). Leptin was not only positively correlated with the BMD of femoral neck and Ward's triangle, but also with body mass, BMI, fasting blood glucose (FBG), total cholesterol and HbAlc (r=0. 219 ～ 0. 509, P<0.05 or P<0.01). Using stepwise regression analysis, body mass was the predictor of BMD at all sites assessed, while the HbAlc and leptin levels could respectively influence BMD at femoral neck and Ward's triangle (r~2= 0. 196 ～ 0. 276, all P< 0. 01). Conclusions It may suggest that differential factors predict the variance of BMD at different sites in elderly men with type 2 diabetes.