2型糖尿病患者骨密度与相关因素分析

目的 探讨2型糖尿病患者骨质疏松的相关因素。方法 采用双能X射线骨密度仪测定120例2型糖尿病患者正位腰椎(L_1-4)、左侧股骨颈、左侧股骨粗隆及左侧股骨干骨密度,根据骨密度值分为骨量正常组、骨量减少组及骨质疏松组,观察各组年龄、病程、体质指数(BMI)、血清骨代谢及相关生化指标的变化,并对上述指标进行对比分析。结果 骨质疏松组在年龄、病程、BMI、血碱性磷酸酶(ALP)、Ⅰ型胶原氨基末端肽(SNTX)及血清25-羟维生素D (25-VitD)水平与正常组比较差异均有统计学意义(P < 0.05),骨量减少组与正常组比较仅年龄的差异有统计学意义(P < 0.05),其他指标无统计学差异(P > 0.05)。直线相关分析显示年龄、BMI及25-VitD与各部位骨密度均相关(P < 0.01或P < 0.05),病程与除腰椎外的其他部位骨密度呈负相关(P < 0.01),ALP与除股骨干之外的各部位骨密度呈负相关(P < 0.05),SCTX、SNTX分别与腰椎、股骨干骨密度呈负相关(P < 0.05)。结论 年龄、病程及低BMI是2型糖尿病患者骨质疏松的危险因素,检测血清25-VitD、ALP、SNTX和SCTX水平在一定程度上有助于判断个体是否易患骨质疏松。

Clinic Analysis of Bone Mineral Density and its Related Factors in Patients with Type 2 Diabetes

Objective To investigate the related factors for osteoporosis in patients with type 2 diabetes mellitus. Methods The bone mineral density（ BMD） at lumbar vertebrae（ L1- 4）,left femur neck,greater trochanter of femur and left Shaft of femur were measured by dual energy X- ray absorptiometry in 120 patients with type 2 diabetes mellitus. The patients were divided into three groups： normal group,osteopenia group and osteoporosis group. The correlations between BMD and age,course of disease,body mass index（ BMI） and serumal indicators were analyzed by multivariate regression analysis. Results there were siginificantly statistical differences in age,course of disease,BMI,ALP,SNTX and 25- Vit D between normal and osteoporosis group（ P〈0. 05）,while there are differences only in course of disease between normal and osteopenia group. Logistic regression analysis showed that BMD of all those locum had independent correlation with age,BMI and 25- Vit D,but also with course of disease except lumbar vertebrae. There was an negative correlation between ALP and BMD of all other locums except left Shaft of femur.Furthermore,SCTX and SNTX had an negative correlation with lumbar vertebrae and left Shaft of femur respectively. Conclusion In patients with type 2 diabetes mellitus,age,course of disease and low BMI are risk factors for osteoporosis,and it may be help ful to anticipate osteoporosis happening in future by detecting serumal 25- Vit D,ALP,SNTX and SCTX.