老年2型糖尿病患者合并骨质疏松症的危险因素分析

Analysis of risk factors of osteoporosis in elder type 2 diabetic patients

目的探讨老年2型糖尿病(type 2 diabetic mellitus,T2DM)患者合并骨质疏松症的危险因素。方法选取2016年5月至2018年4月武汉市第一医院老年病科收治的老年T2DM患者273例,运用双能X线法测定所选取患者的骨密度(bone mineral density,BMD)。根据BMD将273例患者分为骨质疏松(osteoporosis,OP)组125例和非骨质疏松(non osteoporosis,non-OP)组148例。记录两组患者的性别、年龄、病程、体质量指数(bone mass index,BMI)、血钙(Ca)、血磷(P)、碱性磷酸酶(alkaline phosphatase,ALP)、空腹血糖(fasting blood-glucose,FBG)、空腹胰岛素水平(fasting insulin,Fins)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(hight-density lipoprotein lcholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、血清胰岛素样生长因子-1(insulin-like growth factor,IGF-1)水平,并计算稳态模型胰岛素抵抗指数(HOMA-IR),将2组各项指标进行比较。结果 OP组与non-OP组比较,病程、BMI、HbA1c、Scr、IGF-1差异有统计学意义(P<0.05),而年龄、性别、Ca、P、ALP、HOMA-IR、TG、TC、HDL-C、LDL-C差异无统计学意义(P>0.05);二元Logistic回归分析显示病程、BMI、IGF-1与OP有关。结论病程、BMI和IGF-1是影响2型糖尿病合并骨质疏松的相关危险因素。

Objective To explore the risk factors of osteoporosis in elder type 2 diabetic patients(T2 DM). Methods A total of 273 cases of elder T2 DM patients in the First Hospital of Wuhan from May 2016 to April 2018 were collected. Patients were divided to osteoporosis group(OP group, 125 cases) and non-OP group(148 cases) according to the BMD values. Sex, age, course of disease, BMI, levels of blood calcium(Ca), blood phosphorus(P), alkaline phosphatase(ALP), fasting blood-glucose(FBG), fasting insulin(Fins), hemoglobin AIC(HbAlc), serum creatinine(Scr), triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and insulin-like growth factor-1(IGF-1) were recorded. The homeostasis model assessment insulin resistance(HOMA-IR) was calculated. The clinical data were compared between the two groups. Results The course of disease, BMI, HbA1 c, Scr,and IGF-1 were significantly different between patients in OP group and non-OP group(P<0.05). However, age, sex, Ca, P, ALP, HOMA-IR, TG, TC, HDL-C, and LDL-C were not different between the two groups(P>0.05). Logistic regression analysis revealed that longer course of disease, lower BMI, and lower IGF-1 were correlated with osteoporosis. Conclusion The course of disease, BMI, and level of blood IGF-1 are the risk factors of osteoporosis in elder type 2 diabetes patients.