绝经后2型糖尿病妇女血脂水平和骨密度的关系

The relationship between serum lipid level and bone mineral density in postmenopausal women with type 2 diabetes

目的探讨绝经后2型糖尿病妇女血脂和骨密度改变的相关性。方法将290例绝经后2型糖尿病妇女按T值分成骨质疏松组和非骨质疏松组;检测各组患者血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇LDL-C)以及腰椎骨密度(BMD),然后分析血脂和骨密度的关系;对骨密度和血脂、年龄、绝经年龄等变量之间的关系进行多元逐步回归分析。结果(1)绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关(r=-0.305,P=0.001),LDL-C、TG、TC与腰椎BMD无相关;(2)在校正体重指数、年龄和绝经年限影响因素后,绝经后2型糖尿病妇女的HDL-C与腰椎BMD仍存在负相关(r=-0.160,P=0.018),而LDL-C、TG、TC与腰椎BMD仍无相关。(3)在多元逐步回归分析中,HDL-C(β1=-0.199,P=0.005)仍与骨密度独立相关。结论绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关而TC、TG、LDL-C与腰椎BMD无相关。

Objective To investigate the correlation between serum lipid level and bone mineral density in postmenopausal women with type 2 diabetes. Methods Two hundred and ninety postmenopausal females with type 2 diabetes were divided into two groups, according to T score ： osteoporosis group （T ≤ - 2.5） and non-osteoporosis group （ T 〉 - 2.5 ） ; the levels of serum total cholesterol （ TC ） , triglyeeride （ TG ） , high density lipoprotein cholesterol （HDL-C） ,low density lipoprotein cholesterol （LDL-C） and the bone mineral density （BMD） of lumbar spinel-4 were determined, the correlation beween serum lipid and BMD were analyzed. Multiple regression method was used to analyze the relation between BMD and several variables such as age,years since menopause and so on. Results （ 1 ） the HDL-C level was negatively eorrelated with BMD of lumber in postmenopausal females with type 2 diabetes （ r = - 0. 305, P = 0. 001 ） while the LDL-C, TG and TC level was not significantly correlated with BMD;（2） after BMI, years since menopause and age were adjusted, the HDL-C level was still negatively correlated with BMD of lumber in postmenopausal females with type 2 diabetes （r = -0. 160,P =0. 018） while the LDL-C,TG and TC level was still not significantly correlated with BMD. （3） Multiple factor regression analysis showed that the HDL-C level （β1= -0. 199, P = 0. 005 ） was still independently related to BMD of lumber. Conclusions ： （ 1 ） postmenopausal females with type 2 diabetes showed a negative relationship between HDL-C and BMD of lumber while no relationship between TC,TG, LDL-C and BMD of lumbar spine.