绝经后2型糖尿病患者骨密度与胰岛素抵抗和体质成分的关系

目的:观察绝经后2型糖尿病患者(T2DM)骨密度(BMD)的变化,及其与胰岛素抵抗和体质成分的关系。方法:以26例绝经后2型糖尿病女性患者为研究对象,26例年龄、绝经年限、体重指数(BMI)相匹配的绝经后健康女性为正常对照组。应用双能X线骨密度仪测定腰1-4(L1-4)各腰椎骨密度和全身体肌肉、脂肪组织含量,以稳态模型HOMA-IR指数评估胰岛素抵抗。结果:①绝经后T2DM患者L1部位BMD值高于对照组(P<0.05),胰岛素抵抗明显高于对照组(P<0.01)。②多元逐步回归分析显示:T2DM组L1、L2、L3各腰椎BMD均与胰岛素抵抗呈明显正相关(r=0.42,0.45,0.41;P均<0.05),L1部位BMD与肌肉含量正相关(r=0.44,P<0.05)。结论:绝经后2型糖尿病患者腰椎骨密度高于对照组;胰岛素抵抗、肌肉含量可能是T2DM患者BMD的保护因素。

Bone Mineral Density of Type 2 Diabetes in Postmenopausal Women in Relation to Insulin Resistance and Body Composition

Objective:To observe the bone mineral density(BMD)changes in female postmenopausal T2DM patients and to study their relationship with insulin resistance and body components.Methods:Twenty-six cases of postmenopausal women with T2DM and 26cases of normal control were enrolled in this study.The BMD at L1-4of lumbar spine and body muscle and adipose tissue contents were measured by using a dual-energy X-ray absorptiometry.Cubital venous blood was taken at the same time for measuring fasting blood glucose and plasma insulin.Homeostasis model assessment-insulin resistance(HOMA-IR)index was adopted for assessing insulin resistance.Results:BMD values in L1as well as HOMA-IR index were higher in T2DM patients than those in controls.The lumbar spine BMD of L1,L2and L3in T2DM patients was positively correlated with HOME-IR(r=0.42,0.45,and 0.41,respectively,P<0.05).BMD in L1positively correlated with the muscle contents(r=0.44,P<0.05).Conclusion:The lumbar spine BMD in female postmenopausal T2DM patients was higher than that of normal controls.Insulin resistance and muscle content may be BMD protective factors.