老年2型糖尿病患者血浆同型半胱氨酸的表达水平与骨密度的相关性

目的 探讨老年2型糖尿病患者血浆同型半胱氨酸(Hcy)的表达水平及其与骨密度的关系.方法 选取我院2013年2月至2015年2月收治的老年2型糖尿病患者98例,根据骨密度水平分为骨质疏松组(A组34例)、骨量减少组(B组33例)和骨量正常组(C组31例),检查各组患者的血浆Hcy水平及相关临床、生化指标,并与同期年龄相仿的35例正常健康体检者(D组)进行比较.结果 A组、B组的骨密度和体质指数(BMI)明显低于C组、D组,且A组均低于B组,差异均有统计学意义(P<0.05);A、B、C组的糖化血红蛋白(HbA1c)均明显低于D组,差异均有统计学意义(P<0.05);A、B组的Hcy和超敏C反应蛋白(hs-CRP)均明显高于C、D组,A组均高于B组,C组均高于D组,差异均有统计学意义(P<0.05);各组的血钙、血磷、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)比较差异均无统计学意义(P>0.05);Pearson相关性分析显示,骨密度与BMI呈正相关(r=0.28),与Hcy、hs-CRP均呈负相关(r=-0.586、r=-0.632),P值均<0.05.结论 BMI降低、hs-CRP及血浆Hcy水平升高可能与老年2型糖尿病患者骨密度的降低相关,血浆Hcy与hs-CRP水平的升高是老年2型糖尿病患者骨质疏松形成的独立危险因素.

Correlation between plasma Hcy levels and bone mineral density in elderly patients with type 2 diabetes

Objective To investigate the correlation between plasma Hcy levels and bone mineral density in elderly patients with type 2 diabetes. Methods Ninety-eight elderly patients with type 2 diabetes in our hospital from Feb. 2013 to Feb. 2015 were selected and divided into osteoporosis group (group A), osteopenia group (group B) and bone mass normal group (group C) according to the level of bone mineral density. The plasma homocysteine (Hcy) levels, the relevant clinical indexes and biochemical indexes were checked and compared in each group with 35 healthy individuals for check-up of the same age (group D). Results Bone mineral density (BMD) and body mass index (BMI) in group A and group B were significantly lower than those in group C and group D (P<0.05), and the two parameters were significantly lower in group A than group B (P<0.05). The glycosylated hemoglobin (HbA1c) in group A, group B and group C were significantly lower than that of group D (P<0.05). Hcy and high-sensitivity C-reactive protein (hs-CRP) in group A and group B were significantly higher than those in group C and group D (P<0.05), and the two parameters were significantly higher in group A than group B as well as in group C than group D (P<0.05). Blood calcium, blood phosphorus, total cholesterol (TC), triacylglycerol (TG), high densi-ty lipoprotein (HDL) and low density lipoprotein (LDL) had no statistically significant difference between the four groups (P>0.05). Pearson correlation analysis showed that bone mineral density were positively correlated with BMI (r=0.28), and negatively correlated with Hcy, hs-CRP (r=-0.586, r=-0.632), P<0.05. Conclusion Decrease in BMI and increase in hs-CRP and plasma Hcy may be associated with decrease of BMD in elderly patients with type 2 diabetes. The increase of plasma Hcy and hs-CRP levels are independent risk factor of the formation of osteoporo-sis for elderly patients with type 2 diabetes.