2型糖尿病患者合并骨质疏松症的危险因素研究

Risk factors of osteoporosis in patients with type 2 diabetes mellitus

目的研究2型糖尿病(type 2diabetes mellitus,T2DM)患者发生骨质疏松症(osteoporosis,OP)的危险因素,为防治T2DM患者合并OP提供理论依据。方法选取2017年1~12月上海市复旦大学附属中山医院青浦分院收治的T2DM患者193例,根据骨密度水平将患者分为合并OP组(观察组)和未合并OP组(对照组),比较两组患者性别、年龄、病程、血糖、血脂、体质量指数(body mass index,BMI)以及吸烟习惯,对两组差异有统计学意义的因素进行多因素logistic逐步回归分析。结果多因素logistic逐步回归分析男性T2DM患者年龄、BMI、HbA1c、吸烟、服用钙剂1年以上以及体育锻炼的比值比(OR)和95%可信区间(95%CI)分别为1.36 (1.01~3.21),0.75 (0.12~0.90),1.41 (1.22~6.33),4.47(2.01~10.22)和0.62(0.21~0.88)。结论高龄、高HbA1c水平和吸烟为T2DM合并OP的独立的危险因素,高BMI、服用钙剂1年以上和体育锻炼可能是T2DM合并OP的保护因素。

Objective To analyze the risk factors of osteoporosis（OP）among patients with type 2 diabetes mellitus（T2 DM）,and to provide scientific reference for OP prevention and control. Methods A total of 193 patients with T2 DM being treated in Qingpu Branch of Zhongshan Hospital affiliated to Fudan University from January to December 2017 were recruited and divided into OP group（patients with OP）and control group（patients without OP）determined by bone mineral density.The gender,age,disease duration,fasting blood-glucose and blood lipid level,body mass index（BMI）,smoking and physical exercise were compared between the two groups.The factors with significant difference were analyzed using multivariate Logistic regression analysis. Results The odds ratio（OR）and 95% confidence interval（95%CI）of age,BMI,HbA1 c,calcium supplement and physical exercise were 1.36（1.01-3.21）,0.75（0.12-0.90）,1.41（1.22-6.33）,4.47（2.01-10.22）and 0.62（0.21-0.88）,respectively. Conclusions Older age,high HbA1 clevel and smoking are found to be independent risk factors of OP in patients with T2 DM,while high BMI,calcium supplement and physical exercise are the protective factors.