绝经后2型糖尿病患者骨质疏松相关因素分析

Analysis of related factors for osteoporosis in postmenopausal patients with type 2 diabetes mellitus

目的探讨绝经后2型糖尿病（T2DM）患者骨质疏松的相关因素。方法采用双能x线骨密度仪测定79例绝经后T2DM患者的正位腰椎（L1-4）、左股骨颈与左股骨粗隆及左全髋骨密度，根据骨密度值分为骨质疏松组与非骨质疏松组，并对测定的相关化验指标、年龄、病程、绝经年龄、绝经年限及体质指数（BMI）等进行对比分析。结果两组年龄、BMI、白细胞介素6（IL-6）、骨钙素、绝经年限差异均有统计学意义，直线相关分析显示IL-6与骨质疏松（r=0．260，P=0．020）及糖化血红蛋白（GHbAlc）（r=0．259，P=0．023）相关；Logistic多因素回归分析显示，绝经后T2DM患者骨质疏松的发生与年龄独立相关，与BMI独立负相关。结论年龄与低BMI可能是绝经后T2DM患者骨质疏松发生的独立危险因素。

Objective To investigate the morbidity and related factors for osteoporosis in postmenopausal patients with type 2 diabetes mellitus （T2DM）. Methods The bone mineral density （BMD） at lumbar vertebrae（L1-4 ）, left femoral neck, femoral troehanter and total hip were measured by dual energy Xray absorptiometry （DEXA） in 79 postmenopansal patients with T2DM. The patients were divided into two groups： osteoporosis group and non-osteoporosis group. The correlations between BMD and age, course of disease, menopausal age, menopausal duration and body mass index （BMI） were analyzed by muhivariate regression analysis. Results There were significantly statistical differences in age, BMI, interleukin 6 （IL-6）, osteocalcin and menopause duration between two groups. Linear correlation analysis showed IL-6 was positively correlated with osteoporosis （r=0. 260, P=0. 020） and glyeosylated hemoglobin （GHbAlc） （r=0. 259, P=0. 023） . Logistic regression analysis showed that the morbidity of osteoporosis had an independent positive correlation with age, but an independent negative correlation with BMI. Conclusions In postmenopausal patients with T2DM, age and low BMI are independent risk factors for osteoporosis.