2型糖尿病患者骨密度变化与血管病变的相关性研究

目的 探讨2型糖尿病（T2DM）患者骨密度变化与大血管及微血管病变的关系及临床意义.方法 随机选取2011年1月～2012年11月在河南省油田总医院内分泌科住院的T2DM患者180例,全部受试者均检测正位腰椎及左侧股骨骨密度,并行相关血管超声、头颅CT或MRI、眼底及生化指标等检查,并记录每位患者的糖尿病治疗史.按照患者血管病变部位不同分为无血管病变组、大血管病变组、微血管病变组、大血管合并微血管病变组.应用SPSS 17.0统计软件进行统计学分析,所有数据以（x）±s表示,计量资料两组间采用独立样本t检验、双变量PearSon相关分析,多组间比较采用方差分析,计数资料比较采用x2检验.探讨4组患者骨密度变化与大血管及微血管病变的相关性,为防治T2DM所并发的骨质疏松症与大血管及微血管病变提供理论依据.结果 T2DM大血管及微血管病变与骨密度变化密切相关（P＜0.05）;年龄、绝经年限、体重指数（BMI）、糖尿病病程、糖化血红蛋白（HbA1c）是影响Tt2DM患者骨密度变化及血管病变的共同因素（P＜0.05）;使用口服降血糖药物可能加重T2DM血管病变.结论 T2DM患者骨密度变化与大血管及微血管病变密切相关,合并骨质疏松的患者更易并发大血管病变,且年龄、绝经年限、BMI、糖尿病病程、HbA1c是影响T2DM患者骨密度变化及血管病变的共同因素.

Correlation study between bone mineral density change and vasculopathy in patients with type 2 diabetes

Objective To investigate the relationship and its clinical significance between bone mineral density change and macroangiopathy and microangiopathy in patients with type 2 diabetes （T2DM）.Methods 180 cases of inpatients with T2DM in endocrinology department of Henan Oil Field General Hospital were randomly selected from January 2011 to November 2012,all subjects were detected with plain radiographs of lumbar and bone mineral density of left femur,and associated vascular ultrasound,head CT or MRI,fundus examination and biochemical test.The history of dia- betes treatment on each patient was recorded.According to the different fractions of vascular lesions,they were divided into four groups.Statistical analysis was conducted by using SPSS 17.0 statistical software,and all data recorded as ~_＋s. Measurement data between two groups adopted independent sample t test and double-variable Pearson correlation analysis,comparison among multiple groups adopted analysis of variance,count data comparison adopted chi-square test.The correlation between bone mineral density changes and macroangiopathy and microangiopathy was investigated among patients in four groups,in order to providea theoretical basis for the prevention of T2DM complicated with os- teoporosis,macroangiopathy and microangiopathy.Results The macroangiopathy and microangiopathy of T2DM was closely related to bone mineral density changes （P〈0.05）.Age,menopause age,BMI,diabetes duration and HbAlc were common influence factors of bone mineral density change and vasculopathy of T2DM （P〈0.05）.Oral antidiabetic drugs could increase vasculopathy of T2DM.Conclusion The bone mineral density change in patients with T2DM is closely related to macroangiopathy and microangiopathy.T2DM patients combined with osteoporosis are incidental to macroangiopathy.And age,menopause age,BMI,diabetes duration and HbAlc are common influence factors of bone mineral density change and vasculopathy of diabetes.