中老年2型糖尿病患者骨密度变化

目的 了解中老年2型糖尿病(type 2 daibetes,T2DM)患者骨密度(bone mineral density,BMD)变化.方法 采用双能X线吸收法测定2 215例T2DM患者(男1 142例,女1 073例)腰椎正位1～4椎体(L1～4)、左侧髋部股骨颈(Neck)、大转子(Troch)、转子内区(Inter),髋部总体(Htot)和华氏三角(Wa rd) BMD.结果 ①中老年T2DM患者L1～4、Neck、Troch、Inter、Htot和Ward BMD在30岁以后随年龄增加而逐渐降低.各测量部位中Ward区BMD绝对值最低,是BMD变化的敏感的区域.②女性各测量部位BMD均低于男性(P＜0.01).男女L1～4、Inter、Htot、Neck、Troch、和Ward区BMD分别为0.88(0.10) vs 0.78(0.22)、1.12(0.19) vs 1.00(0.23)、0.96(0.16) vs0.83(0.15)、0.82(0.15) vs 0.73(0.18)、0.69(0.14) vs 0.57、0.60(0.18) vs 0.52(0.22).③按照体质量指数(BMI)分为4组后比较BMD,随着BMI值的增加,各测量部位BMD呈上升趋势.结论 中老年T2DM患者BMD骨峰值出现在30～40岁.T2DM患者女性BMD值在各个测量部位均低于男性.各部位BMD随BMI增加呈上升趋势.

Changes of bone mineral density in middle aged and elderly type 2 diabetic patients

Objective To investigate the changes of bone mineral density（BMD） in middle aged and elderly type 2 diabetic（T2DM） patients. Methods Dual energy X-ray absorptiometry was used to measure BMD at posteroanterior lumbar spine（L1-4） and left femoral neck（Neck）,femoral trochanter（Troch）,intertrochanter（Inter）,total hip（Htot） and ward triangle（Ward） in 2 215 T2DM patients（1 142 males,1 073 females）. Results ①BMD of L1-4,Neck,Troch,Inter,Htot and Ward decreased after 30 years old in T2DM patients.In all sites,BMD of Ward triangle had the lowest value and this is a sensitive area to predict low BMD.②BMD of the female was lower than that of the male at various sites（P0.01）.The BMD of L1-4,Inter,Htot,Neck,Troch,Ward area in male vs female was respectively 0.88（0.10） vs 0.78（0.22）,1.12（0.19） vs 1.00（0.23）,0.96（0.16） vs 0.83（0.15）,0.82（0.15） vs 0.73（0.18）,0.69（0.14） vs 0.57,0.60（0.18） vs 0.52（0.22）.③All subjects were divided in four groups according to body mass index（BMI） for comparison of BMD.BMD in all the sites showe increase trends with rising BMI. Conclusion Peak BMD was observed at the age range of 30-40 years at the various sites in patients with T2DM.Female has lower BMD than male at various sites in patients with T2DM.BMD at the various sites increased with rising BMI