绝经后女性2型糖尿病患者腰椎骨质疏松的影响因素研究

目的探讨绝经后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者腰椎骨质疏松(osteoporosis,OP)的影响因素。方法选取2018年3月至2019年10月在武汉科技大学附属孝感医院内分泌科住院的绝经后女性T2DM患者186例为研究对象,按腰椎骨密度T值分为骨质疏松组(OP组)和非骨质疏松组(NOP组)。收集一般资料(年龄、身高、体重、妊娠次数、生育次数、绝经年龄、DM病程、DM家族史、高血压、脂肪肝);血检指标(Hb A1c、FPG、Fins及生化);采用双能X线骨密度仪测量腰椎的骨密度T值和腰椎、股骨的骨髓脂肪含量(LFC、FFC)。分析OP组和NOP组指标的差异及腰椎OP的影响因素。采用SPSS 26.0软件进行统计学分析,使用t检验、非参数检验、卡方检验,Pearson和Spearman相关性分析,二元Logistic回归分析,P0.05为差异有统计学意义。结果 OP组年龄、FFC、ALP、HBDH、LDH、绝经年限、妊娠次数、生育次数高于NOP组(P 0.05),OP组体质量指数(BMI)、GGT低于NOP组(P0.05);两组在FPG、Fins、Hb A1c、DM病程、DM家族史、高血压、脂肪肝、LFC、UA、Ca~(2+)、Mg~(2+)、TC、TG、CK上没有差异(P0.05)。腰椎骨密度的二元Logistic回归分析显示,年龄、FFC、ALP、绝经年限、生育次数是腰椎OP的危险因素(OR值分别为1.131、1.072、1.029、1.127、1.857),BMI是腰椎OP的保护因素(OR值为0.913)。结论年龄、FFC、ALP、绝经年限、生育次数是腰椎OP的危险因素,BMI是腰椎OP的保护因素。

Study on the influential factors of lumbar osteoporosis in postmenopausal women with type 2 diabetes mellitus

Objective To investigate the influencing factors of lumbar osteoporosis (OP) in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods A total of 186 postmenopausal women with T2DM who were admitted to the Department of Endocrinology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from March 2018 to October 2019 were selected as subjects. The patients were divided into osteoporosis group (OP group) and non-osteoporosis Group (NOP group) according to T value of lumbar BMD. The general data were collected (age, height, weight, pregnancy times, birth times, age of menopause, course of DM, and family history of DM, hypertension history, fatty liver). HbA1C, FPG, Fins, and biochemistry were examined. BMD T values of the lumbar vertebrae and bone marrow fat content of the lumbar vertebrae and femur (LFC, FFC) were measured with dual energy X-ray absorptiometry. The difference of indexes between OP group and NOP group and the influencing factors of lumbar OP was analyzed using a SPSS 26.0 software. T test, non-parameter test, Chi-square test, Pearson and Searman correlation analysis, and binary logistic regression analysis were applied. P<0.05 was considered significant difference. Results Age, femoral marrow fat content, ALP, HBDH, LDH, menopausal years, pregnancy times, and birth times were higher in OP group than in NOP group (P<0.05). BMI and GGT were lower in OP group than in NOP group (P<0.05). There were no significant differences in FPG, Fins, HbA1C, course of DM, family history of DM, hypertension history, fatty liver, LFC, UA, Ca2+, Mg2+, TC, TG, and CK between the two groups (P>0.05). Binary logistic regression analysis of lumbar BMD showed that age, FFC, ALP, menopausal year, and birth times were the risk factors of lumbar OP (OR value was 1.131, 1.072, 1.029, 1.127, and 1.857, respectively). BMI was a protective factor for lumbar OP (OR=0.913). Conclusion Age, FFC, ALP, menopause year, and birth times are the risk factors of lumbar OP. BMI is the protective factor of lumbar OP.