非老年成人2型糖尿病合并骨质疏松的相关因素分析

目的：探讨非老年成人2型糖尿病（type 2 diabetes mellitus，T2DM）患者合并骨质疏松的相关因素。方法：分析非老年成人T2DM 230例患者的临床相关资料，包括性别、年龄、体质量指数（body mass index，BMI）、腰围、空腹血糖（fasting blood glucose，FBG）、2 h餐后血糖（postprandial blood glucose，PBG）、空腹胰岛素（insulin，INS）、C肽、糖化血红蛋白（glycosylated hemoglobin，HbA1c）、胰岛素抵抗指数（insulin resistance index，HOMA-IR）。采集研究对象空腹血清，应用生化分析仪测定患者总胆固醇（total cholesterol，TC）、三酰甘油（triglyceride，TG）、低密度脂蛋白胆固醇（low density lipopro-tein-cholesterol，LDL-C）和高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDC-C）。采用I’acn双能X线骨密度仪检测受试者腰椎处骨密度值（bone mineral density，BMD）。通过两独立样本t检验以及Logistic回归分析该样本T2DM患者合并骨质疏松的相关因素。结果：230例患者分为骨量正常组与骨量减少组，骨量减少组与骨量正常组在性别、年龄、HbA1c、FBG、PBG及非酒精性脂肪肝所占比例差异均无统计学意义。骨量减少组的BMI、腰围、体脂含量均低于骨量正常组（P＆lt;0.05），骨量减少组的空腹INS、C肽、IR均低于骨量正常组（P＆lt;0.05），骨量减少组的TC、TG、LDL均高于骨量正常组（P＆lt;0.05），而HDL 则低于骨量正常组（P＆lt;0.05）。 Logistic 回归分析显示，最终变量BMI、TC、空腹C肽进入回归方程（P＆lt;0.05），OR的估计值分别为0.735、1.157、0.606，OR的95%置信区间分别是0.535~0.921、1.102~1.314、0.431~0.854。结论：在非老年的成人T2DM患者中，随着TC水平的增加，以及BMI指数、空腹C肽值的降低，患者合并骨质疏松症的风险加大。

The relationship between non-elderly adults with type 2 diabetes mellitus and osteoporosis

Objective： To investigate the relationship between non-elderly adults with type 2 diabetes mellitus and osteo-porosis. Methods： 230 cases of non-elderly adults with T2DM patients were collected. The clinical characteristics including sex, age, body mass index（BMI）, waistline, fasting blood glucose（FBG）, postprandial blood glucose（PBG）, fasting insuline （FINS）, fasting CPT, HBA1C, HOMA-IR were collected for each patient. Fatty liver by ultrasound results and bone mineral density（BMD） were measured. The serum levels of total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterol （LDL-C）, and High density lipoprotein-cholesterol（HDL-C） were measured. The bone mineral density（BMD） of subjects in lumbar spine were measured using dual-energy X-ray absorptiometry（dexa）. By two independent samples t test and Logistic regression analysis of the sample in patients with type 2 diabetes combined osteoporosis related factors. Results： There were only four cases of the lumbar spine BMD values conform to the WHO the prescribed standards for osteoporosis in the initial selection of 230 cases of non-elder adults with type 2 diabetes as extreme value to remove. The rest of the selected patients were divided into normal bone mass and osteopenia group. There was no significance in clinical indexes including sex,age, HBA1C,FBG, PBG, and the ratio of the nonalcoholic fatty liver disease between two groups（P＆gt;0.05）. The BMI, waistline, fat%, FINS, CPT,IR,HDL of the osteopenia group were lower than the normal bone mass group（P＆lt;0.05）. The TC, TG, LDL of the osteopenia group were higher than the normal bone mass group （ P＆lt;0.05 ） . The result of logistic regression analysis shown that final variables BMI, TC, fasting C peptide into the regression equation（P＆lt;0.05）, the estimate of the OR, re-spectively were 0.735, 1.157, 0.606. The 95% confidence interval of the OR are respectively were 0.535-0.921, 1.102-1.314, 0.431-0.854. It was shown that high TC, low weight and fasting C peptide were risk factors of T2DM with osteoporo-sis. Conclusion：With the increase of TC levels, as well as lower BMI, fasting C peptide value of the non-elderly adults with type 2 diabetes mellitus, the risk of osteoporosis was combined.