2型糖尿病患者微血管病变与骨密度相关性研究

目的探讨2型糖尿病患者微血管病变与骨密度的相关性。方法本横断面研究共纳入2 170例2型糖尿病患者(包括1 188名绝经后女性和982名50岁男性)。根据24 h尿蛋白水平对这些受试者进行分组:一组(30 mg)、二组(30～299mg)和三组(300 mg)。通过双能X射线吸收测定法评估其腰椎、髋部和股骨颈的骨密度。视网膜病的眼底照相和24 h尿蛋白作为2型糖尿病中微血管病的标志物。比较受试者的特征和骨密度。多变量分析用于研究骨密度与微血管病之间的关联。结果第三组在两种性别中具有最低的骨密度水平。在调整年龄、体重指数、高血压、高脂血症、糖尿病状态、肝功能、肾功能、性激素和25(OH)维生素D后,多变量分析显示,微血管病变与女性骨密度呈负相关(腰椎:r=-0. 522,P0. 001;髋关节:r=-0. 301,P=0. 010;股骨颈:r=-0. 314,P=0. 009),男性未发现相关性。结论绝经后女性2型糖尿病患者的微血管病变与骨密度之间呈负相关。

Correlation between the microangiopathy and bone mineral density in type 2 diabetic patients

Objective To observe the correlation between microangiopathy and bone mineral density in patients with type 2 diabetes. Methods A total of 2 170 patients with type 2 diabetes mellitus (1 188 postmenopausal females and 982 males aged 50 years) were included in our cross-sectional study. These patients were grouped according to 24-hour urine protein level: Group I (<30 mg), Group II (30-299 mg) and Group III ( 300 mg). Bone mineral density of the lumbar spine, hip and femoral neck was evaluated by dual-energy X-ray absorptiometry. Fundus oculi photography for diabetic retinopathy and 24-h urine protein for diabetic nephropathy were used as markers of microangiopathy in type 2 diabetes mellitus. Characteristics of the patients and bone mineral density were compared. Multivariate analysis was used to study the association between bone mineral density and microangiopathy. Results Group III had the lowest bone mineral density level in both genders. Multivariate analysis revealed that microangiopathy was negatively correlated with bone mineral density in females (lumbar: r = -0.522, P<0.001; hip: r = -0.301, P=0.010; femoral neck: r = -0.314, P=0.009), but not in males, after adjustment for age, body mass index, hypertension, hyperlipidemia, diabetic status, hepatic function, kidney function, sex hormones and 25(OH) vitamin D. Conclusion These results demonstrated an independent negative correlation between microangiopathy and bone mineral density in postmenopausal female type 2 diabetes mellitus patients.