老年2型糖尿病发生骨质疏松的临床多因素分析

目的 探讨老年2型糖尿病(T2DM)患者发生骨质疏松的影响因素. 方法 根据患者的骨密度值将患者分为骨量正常(NOP)组、低骨量(LBMD)组、骨质疏松(OP)组,对比3组在年龄、糖尿病病程、体质量指数(BMI)、胱抑素C(Cys C)、经皮氧分压检查(TcPO2)、糖化血红蛋白(HbA1c)、尿C肽(U-CP)等指标之间的差异,并进行相关性分析. 结果 (1)与NOP组相比,LBMD及OP组年龄、病程显著性升高,U-CP显著性下降；(2)OP组BMI、Cys C显著低于NOP组；(3)OP组年龄显著高于LBMD组,而BMI显著低于LBMD组(P＜0.05或P＜0.01).老年T2DM患者的BMD与年龄、病程呈负相关,与BMI、U-CP呈正相关.逐步多元回归分析显示U-CP是BMD的正性预测因子. 结论 老年T2DM患者并发骨质疏松与多因素有关,包括高龄、低体质量、病程长、胰岛功能差等.

Clinical multivariate analysis of osteoporosis in elderly patients with type 2 diabetes

Objective To investigate the influencing factors of osteoporosis in elderly patients with type 2 diabetes(T2DM).Methods 298 patients with T2DM were divided into 3 groups(according to their bone mineral density):normal bone mineral density(NOP) group,low bone mineral density(LBMD) group,osteoprosis(OP) group.Age,diabetes duration,body mass index(BMI),Cystatin C(Cys C),transcutaneous tissue oxygen tension(TcPO2),glycosylated hemoglobin(HbA1c),urinary C-peptide(U-CP) were compared among three groups.The correlation analysis was used to analyze the factors of OP.Results Compared with NOP group,patients in LBMD and OP group had older age,longer diabetic course,lower U-CP.BMI,Cys C level of patients in OP group were lower than those in NOP group,while the difference in age,BMI was statistically significant between OP and LBMD group(P<0.01 or P<0.05).BMD in elderly patients with T2DM was negatively correlated with age,disease course,but positively correlated with BMI and U-CP.Meanwhile,BMD was independently correlated with U-CP.Conclusions Osteoporosis in elderly patients with T2DM is related to a number of risk factors,including advanced age,low body weight,long-term history of diabetes,insulin dysfunction.