中老年男性及绝经后女性2型糖尿病患者SUA/CR与BMD、BTMs的相关性

The relationship between SUA/CR and BMD,BTMs in middle-aged and elderly males and postmenopausal females with T2DM

目的回顾性研究中老年男性及绝经后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者血尿酸肌酐比(SUA/CR)与骨代谢标志物及骨密度(bone mineral density,BMD)的关系。方法纳入在我院住院的T2DM患者668例,将中老年男性依据SUA/CR水平进行三分位分组,依次分为M1组、M2组、M3组;绝经后女性依据SUA/CR水平进行三分位分组依次分为F1组、F2组、F3组。结果①中老年男性与绝经后女性SUA/CR水平越高,骨质疏松(osteoporosis,OP)或骨量减少比例越低;②中老年男性中,M1组股骨颈BMD最低,1型胶原C端交联肽(CTX)、骨钙素(N-OC)最高(P<0.05);绝经后女性中,F3组患者大转子、股骨颈、腰椎1~4(L_(1~4))、Ward’s三角BMD最高;F1组N-OC、CTX最高(P<0.05);③中老年男性SUA/CR与股骨颈BMD正相关,与N-OC、CTX、总1型胶原N端延长肽(P1NP)负相关(P<0.05);绝经后女性SUA/CR与L_(1~4)、股骨颈、大转子、Ward’s三角BMD及VD正相关,与N-OC、P1NP、CTX负相关(P<0.05);④Logistic回归分析显示SUA/CR是OP或骨量减少的保护性因素。结论高水平SUA/CR是中老年男性及绝经后女性T2DM患者OP及骨量减少的保护性因素。

Objective A retrospective research was designed to analyze the relationship between serum uric acid to creatinine ratio(SUA/CR)and bone turnover markers,bone mineral density(BMD)in middle-aging males and postmenopausal females with type 2 diabetes mellitus(T2DM).Methods We recruited 333 male and 335 female patients with T2DM and assigned them into 3 groups according to the level of SUA/CR respectively.Males were divided into M1,M2,and M3 group.Females were divided into F1,F2,and F3 group.Results(1)The higher the SUA/CR levels,the lower the proportion of osteoporosis or osteopenia presented in middle-aging males and postmenopausal females.(2)In middle-aging males,BMD of the femoral neck was the lowest in M1 group,and n-mid osteocalcin(N-OC)and c-terminal crosslinking peptide of type 1 collagen(CTX)were the highest in M1 group(P<0.05).In postmenopausal females,the BMD of lumbar 1-4,femoral neck,Ward’s triangle and great trochanter were the highest in F3 group(P<0.05).The highest levels of N-OC and CTX levels were in F2 group(P<0.05).(3)Pearson correlation analyses revealed that SUA/CR was significantly and positively associated with BMD of the femoral neck and negatively associated with N-OC,CTX,and P1NP in middle-aging male patients(P<0.05).SUA/CR was significantly and positively associated with BMD and VD of the femoral neck,lumbar L 1-4,Ward’s triangle,and great trochanter and negatively associated with N-OC,CTX,and P1NP in postmenopausal patients.(4)Logistic regression analysis indicated that SUA/CR was a protective factor for osteoporosis and osteopenia in middle-aging males and postmenopausal patients with T2DM.Conclusion High SUA/CR level is a protective factor for osteoporosis and osteopenia in middle-aging males and postmenopausal females with T2DM.