老年男性2型糖尿病患者骨质疏松相关因素分析

［摘要］目的: 探讨老年男性2型糖尿病患者发生骨质疏松的危险因素。方法: 选取154例老年男性2型糖尿病住院患者，采用双能X线骨密度仪测定患者骨密度，根据测定结果将其分为骨密度正常组、骨量减少组和骨质疏松组，测定体质量指数（BMI）、糖化血红蛋白（HbA1c）、空腹及餐后2 h血糖、空腹及餐后2 h C肽、血Ca2+、总胆固醇、血浆三酰甘油、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL C）、血尿酸、超敏C反应蛋白（hs CRP）等指标。结果： ① 与骨密度正常组相比，骨量减少组和骨质疏松组患者的年龄、糖尿病病程均明显增高（P<0.05），而BMI明显减低（P<0.01）。② 与骨密度正常组相比，骨量减少组和骨质疏松组患者的HbA1c、hs-CRP均明显增高（P<0.05）, 空腹及餐后2 h C肽明显降低（P<0.05），而空腹及餐后2 h血糖、血Ca2+、总胆固醇、血浆三酰甘油、HDL-C、LDL-C、 血尿酸等指标3组间差异无统计学意义（P>0.05）。结论： 老年男性2型糖尿病患者的骨密度与患者的年龄、病程和BMI有关，其中BMI是保护性因素，胰岛功能差、长期血糖控制不佳是导致骨质疏松的危险因素；hs CRP在老年男性2型糖尿病患者骨质疏松的发生中有一定的作用。

Analysis of osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus

[Abstract]Objective: To study the osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus. Methods: A total of 154 elderly male patients with type 2 diabetes were divided into three groups: normal group, osteopenia group and osteoporosis group．Bone mineral density(BMD) were measured by dual-energy X-ray absorptiometry(DXA). BMI, HbA1c, FBG, PBG, fasting C peptide, postprandial C peptide, serum calcium (Ca2+), TG, TC, LDL-C，HDL-C，serum uric acid and hs-CRP were measured． Results: The age and duration of diabetes in osteopenia group and osteoporosis group were significantly higher than those of normal group(P<0.05), while BMI in osteopenia group and osteoporosis group was significantly lower than that of normal group(P<0.01). HbA1c and hs CRP significantly increased in osteopenia group and osteoporosis group compared with normal group, while fasting C peptide, postprandial C peptide significantly decreased. There was no significant difference in FBG, PBG, serum calcium (Ca2+), TC, TG， HDL C, LDL C， and serum uric acid among the three groups(P>0.05). Conclusion: The BMD of elderly male type 2 diabetes patients may be correlated with the age, duration of diabetes and BMI. Bigger BMI may be a protective factor, while poor insulin function and poor control of blood glucose may be risk factors. In addition， inflammatory factor hs CRP may play roles in the pathogenesis of osteoporosis in elderly male type 2 diabetes patients.