河南地区老年2型糖尿病患者骨质疏松与肌少症的相关性研究

Correlation between osteoporosis and sarcopenia in elderly patients with type 2 diabetes mellitus in Henan Province

目的探讨河南地区老年2型糖尿病患者骨质疏松与肌少症的相关性。方法选取2020年1月至2021年2月于郑州市第九人民医院内分泌代谢科住院的412例老年2型糖尿病患者作为研究对象,同期郑州市第九人民医院正常体检老年人308例作为对照组,记录临床资料,完善实验室检查,应用DXA扫描仪进行全身体成分分析,测定全身肌肉含量、四肢骨骼肌质量、腰椎1~4骨密度、全髋骨密度、握力等。采用χ^(2)检验、t检验、多元Logistic回归分析。结果①T2DM组肌少症检出率(30.83%)明显高于对照组(21.10%)(P<0.05)。②老年2型糖尿病肌少症组骨质疏松的患病率明显高于非肌少症组(P<0.05)。肌少症组BMI、25(OH)D3、腰椎1~4骨密度、全髋骨密度、四肢骨骼肌质量、四肢骨骼肌指数、上肢肌肉含量、下肢肌肉含量明显低于非肌少症组(P<0.05),肌少症组糖尿病病史、FBG、HbA1c等指标明显高于非肌少症组(P<0.05)。③低BMI、糖尿病病程、HbA1c、低全髋骨密度、低25(OH)D3是肌少症的危险因素(P<0.05)。结论对于老年2型糖尿病患者,低BMI、糖尿病病程、HbA1c、低全髋骨密度、低25(OH)D3等因素与肌少症的发生具有关联性,可认为这些因素是肌少症的危险因素。随着骨骼肌肌肉质量的减少,大多会出现骨量下降。骨质疏松症和肌少症,两者在发病机制上存在一定的关联性。

Objective To investigate the correlation between osteoporosis and sarcopenia in elderly patients with type 2 diabetes in Henan.Methods A total of 412 elderly patients with type 2 diabetes who were hospitalized in the Endocrinology Department of the Ninth People’s Hospital of Zhengzhou from January 2020 to February 2021 were selected as the research subjects.During the same period,308 elderly patients with normal physical examination in our hospital were selected as the control group,and clinical data were recorded.Complete laboratory examinations,use DXA scanner for whole body composition analysis,determine body muscle content,limb skeletal muscle mass,lumbar spine 1~4 bone density,total hip bone density,grip strength,etc.χ^(2)test,t test,and multiple logistic regression analysis were used.Results①The detection rate of sarcopenia in the T2DM group(30.83%)was significantly higher than that of the control group(21.10%)(P<0.05).②The prevalence of osteoporosis in the elderly type 2 diabetic sarcopenia group was significantly higher than that in the non-sarcopenia group(P<0.05).The BMI,25(OH)D3,waist 1~4 bone density,total hip bone density,limb skeletal muscle mass,limb skeletal muscle index,upper limb muscle content,and lower limb muscle content in the sarcopenia group were significantly lower than those in the non-sarcopenia group(P<0.05),the history of diabetes,FBG,HbA1c,etc.in the sarcopenia group were significantly higher than those in the non-sarcopenia group(P<0.05).③Low BMI,diabetes course,HbA1c,low total hip bone density,and low 25(OH)D3 are risk factors for sarcopenia(P<0.05).Conclusion Low BMI,duration of diabetes,HbA1c,low total hip bone density,and low 25(OH)D3 are risk factors for sarcopenia in elderly patients with type 2 diabetes.The decrease in skeletal muscle muscle is accompanied by a decrease in bone mass.There is a certain correlation between osteoporosis and sarcopenia in the pathogenesis.