2型糖尿病患者骨密度情况及相关影响因素分析

摘要： 目的 探讨 2 型糖尿病（T2DM）患者骨密度（BMD）情况及其合并骨质疏松症（OP）的相关影响因素。方法 采用双能 X 线骨密度仪(DEXA)测定 220 例 T2DM 患者股骨颈（N）及腰椎 1~4(L1~4)的 BMD， 按 BMD 分为骨含量正常、 骨含量减少及 OP 组， 比较各组临床、 生化指标， 分析 T2DM 合并 OP 的影响因素。结果 OP 组女性比例、 年龄、 T2DM 病程、 糖化血红蛋白 （HbA1c） 高于骨含量正常组和骨含量减少组， 体质指数 （BMI） 低于骨含量正常组和骨含量减少组、 高密度脂蛋白胆固醇（HDL-C）低于骨含量正常组而高于骨含量减少组； 骨含量减少组年龄、 T2DM 病程、 HbA1c 高于骨含量正常组， BMI、 HDL-C 低于骨含量正常组（均 P < 0.05）； 3 组腰臀比、 收缩压（SBP）、 舒张压（DBP）、 绝经后女性 （PMW） 比例、 空腹血糖 （FPG）、 餐后 2 h 血糖 （2 hPG）、 血磷、 血钙、 总胆固醇 （TC）、 三酰甘油 （TG）和低密度脂蛋白胆固醇（LDL-C）差异无统计学意义。高龄、 女性、 T2DM 病程长、 高 FPG、 高 2 hPG， 高 HbA1c 为 T2DM 患者合并 OP 的危险因素。结论 高龄、 女性 T2DM 患者为发生 OP 的高危人群， 应定期监测其血糖及 HbA1c 等指标， 及时调整治疗方案。

The analysis on factors related to BMD in patients with type 2 diabetes

Abstract: Objective To explore related factors affecting bone mineral density (BMD) and osteoporosis (OP) in pa? tients with type 2 diabetes mellitus (T2DM). Methods Dual-energy X-ray absorptiometry was used to measure BMD of the femoral neck and the lumbar vertebrae in 220 patients with T2DM. All the patients were divided into three groups: normal bone mass group, decreased bone mass group and OP group according to the value of BMD. The clinical data and biochemi? cal indicators were compared and analyzed between these groups, and the influencing factors of T2DM and OP were ex? plored. Results Compared with normal bone mass group and decreased bone mass group, there were more older patients, longer course of T2DM, lower BMI and high density lipoprotein cholesterol (HDL- C), and higher glycated hemoglobin (HbA1c) level in OP group. There were significantly higher age, longer course of T2DM, higher level of HbA1c, and lower levels of BMI, HDL-C in decreased bone mass group than those of normal bone mass group (P<0.05). There were no signifi? cant differences in waist-to-hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP), postmenopausal women (PMW) ratio, fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), blood phosphorus, calcium, total choles? terol (TC), three acyl glycerin (TG) and low-density lipoprotein cholesterol (LDL-C) between three groups. The risk factors for T2DM combined with OP were older, female, long duration of T2DM, higher levels of FPG, 2hPG and HbA1c. Conclu? sion Older and female T2DM patients were high-risk group of OP. The treatment plan should be timely adjusted by regular? ly monitoring indexes of blood glucose and HbA1c.