糖尿病患者骨密度与胰岛素、糖化血红蛋白、体质量指数的相关性分析

Correlation analysis of bone mineral density with serum insulin, HbA1C and body mass index in patients with diabetes mellitus

目的:探讨糖尿病患者的骨密度改变及相关影响因素。方法:采用双能X线吸收法测定了140例糖尿病患者(1型糖尿病36例,2型糖尿病104例)及60例健康人L2～L4椎体、股骨近端(股骨颈、大转子、Ward's三角区)的骨密度,并同时测定了体质量指数(bodymassindex,BMI)、糖化血红蛋白(HbA1C)及空腹胰岛素水平。结果:1型糖尿病组骨密度(g/cm2)除大转子部位(0.924±0.12)外,其余部位骨密度均明显低于2型糖尿病及健康对照组(t=1.994～2.936,P<0.01～0.05),2型糖尿病组与健康对照组之间各部位骨密度差异无显著性意义(P>0.05)。1型糖尿病组骨质疏松或骨量减少的发生率(83.3%)明显高于2型糖尿病组(38.5%)和健康对照组(20.0%)(χ2=20.226～27.74,P<0.01)。空腹胰岛素水平(mU/L)1型糖尿病组(2.29±0.38)明显低于2型糖尿病组(15.26±3.37)及健康对照组(15.38±2.53)(t=2.912～3.014,P<0.01)。BMI(kg/m2)2型糖尿病组(27.3±4.1)明显高于健康对照组(24.3±2.8)与1型糖尿病组(22.5±3.3)(t=2.317～3.014,P<0.05)。结论:糖尿病患者骨密度与胰岛素水平、HbA1C,BMI显著相关。

AIM:To explore the changes of bone mineral density (BMD) and the relative fact ors. METHODS:The BMD of lumbar spine(L2-L4) and the proximal femur (neck of femur, greater trochanter and Ward's triangle) was measured with dual energy X-ray ab sorptiometry (DEXA) in 140 diabetics (36 with type 1 diabetes and 104 with type 2 patients) and 60 healthy subjects, meanwhile, the body mass index (BMI), HbA1C and fasting serum insulin were also measured. RESULTS:The values of BMD (g/cm2) in the type 1 diabetes group [except that of greater trochanter (0.924±0.12)] were obviously lower than those in the type 2 diabetes group and normal control group (t=1.994-2.936, P< 0.05), there was no significant difference between the type 2 diabetes and normal control groups (P >0.05). The incidence rate of osteoporosis and bone loss in the type 1 diabetes group (83.3%) was obviously higher than those in the type 2 diabetes group (38 .46%) and normal control group (20%) (χ2=20.226-27.74,P< 0.01). The fasting serum insulin (mU/L) in the type 1 diabetes group (2.29±0.38) was significantly lower than those in the type 2 diabetes group (15.26±3.37) and normal control group (15.38±2.53) (t=2.912-3.014,P< 0.01). BMI in the type 2 diabetes group ( 27.3±4.1) was obviously higher than those in the type 1 diabetes group (22.5±3 .3) and normal control group (24.3±2.8) (t=2.317-3.014,P< 0.05). CONCLUSION: BMD is significantly associated with serum insulin, HbA1C and BMI in patients with diabetes mellitus.