人血清β2微球蛋白对糖尿病患者骨质疏松症诊断价值的临床分析

Clinical analysis of diagnosis value on blood β2 microglobulin in diabetic patients’ osteoporosis

目的探讨血清β2微球蛋白初步诊断糖尿病患者骨质疏松的临床价值。方法选取2023年1月至7月聊城市第二人民医院内分泌科的165例患者为研究对象,其中男83例,女82例。患者均使用双能X线吸收法(DXA)骨密度测量仪测定腰椎骨密度,记录相应的T值、Z值。定量检测每位患者的静脉血清中葡萄糖、糖化血红蛋白、β2微球蛋白。同时,记录每位患者的年龄、身高、体重及体质量指数(BMI)等基本临床信息。符合本研究纳入排除标准的患者共165例,纳入骨质疏松组81例,非骨质疏松组84例。以DXA骨密度仪测量结果参考骨密度正常值,T值≥-1.0者为非骨质疏松组,T值≤-2.5者诊断骨质疏松。通过绘制受试者工作特征曲线(ROC)及计算曲线下面积(AUC)验证血清β2微球蛋白对糖尿病人群患骨质疏松症的诊断价值。结果骨质疏松组和非骨质疏松组患者的年龄、性别比例、身高、体重、BMI、血糖及糖化血红蛋白等临床指标的差异无统计学意义(P>0.05);血清β2微球蛋白与糖尿病人群中骨质疏松症的发病密切相关(B=0.36,P<0.05),通过绘制ROC曲线测得的AUC值为0.73,其95%CI为(0.64,0.82)(P<0.05);当血清β2微球蛋白1.94 mg/L时,对识别糖尿病人群患骨质疏松症的敏感度为0.94,特异度为0.54。结论血清β2微球蛋白对糖尿病人群患骨质疏松症有较好的初步诊断价值。

Objective Explore serumβ2 clinical significance of microglobulin in the preliminary diagnosis of osteoporosis in diabetes patients.Methods A total of 165 diabetic patients in the Department of Endocrinology in the Second People’s Hospital of Liaocheng were selected as the research objects,including 83 males and 82 females from January to July 2023.Use dual energy X-ray absorptiometry(DXA)to measure the non-stressed radial and distal 1/3 of the ulna in each patient,record the corresponding T value and Z value,and quantitatively measure theglucose,glycosylated hemoglobin,andβ2 microglobulin in each patient.At the same time,basic clinical information such as age,height,weight and body mass index(BMI)of each patient were recorded.Osteoporosis was diagnosed by DXA.T value≥-1.0 was non-osteoporosis group,and T value≤-2.5 was osteoporosis group.Receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to check the diagnostic value ofβ2 microglobulin in diabetic osteoporosis.Results There were no significant differences in clinical indicators such as age,sex ratio,height,weight,BMI,blood sugar and glycosylated hemoglobin between the osteoporosis group and the non-osteoporosis group(P>0.05).Bloodβ2 microglobulin was closely related to diabetic osteoporosis(B=0.36,P<0.05),and the AUC value measured by drawing the ROC curve was 0.73.When bloodβ2 microglobulin was 1.94,it was effective for identifying diabetic patients.The sensitivity of osteoporosis was 0.94,and the specificity was 0.54.Conclusion Serumβ2 microglobulin has a good preliminary diagnostic value for osteoporosis in diabetes patients.