男性糖尿病患者身体成分变化与骨密度相关性分析

Correlation analysis between body composition and bone mineral density in male patients with type 2 diabetes mellitus

目的分析男性2型糖尿病(DM)患者身体成分变化与骨密度(BMD)的关系。方法采用双能X线BMD检测仪,对88例男性2型DM患者(DM组)和97例男性非DM患者(非DM组)进行腰椎(L1～L4)正位、左股骨和全身BMD检测和身体成分检测,并分析比较。结果(1)两组间所测部位BMD均无显著差异,但DM组全身、躯干和左大腿脂肪质量,左大腿肌肉质量均比非DM组显著降低。(2)在DM组,体重与腰椎BMD、左髋各部BMD和全身BMD等呈显著正相关;体重指数与左股骨各部(Wards三角除外)BMD和全身BMD等呈显著正相关;全身脂肪质量与L1、L3和全身BMD等呈显著正相关;左大腿肌肉质量分别与L2、L3、股骨颈、股骨干和全身BMD等呈显著正相关。(3)在非DM组,体重、体重指数和各部组织成分质量均与全身BMD呈显著正相关。体重、体重指数、全身脂肪质量和躯干脂肪质量均分别与腰椎BMD、左股骨各部BMD等呈显著正相关;全身肌肉质量与左股骨各部BMD(Wards三角除外)、L1BMD呈显著正相关;左大腿肌肉质量也与左股骨各部BMD呈明显正相关;躯干肌肉质量与股骨颈BMD呈显著正相关。结论男性DM患者身体成分变化主要表现为脂肪质量和左大腿肌肉质量明显减少,身体成分与BMD存在一定相关性,但与非DM者相比有较多不同,其差异可能与糖尿病引起的代谢异常有关。

Objective To study the relationships between body composition and bone mineral density （BMD） in male patients with type 2 diabetes mellitus （DM）. Methods 88 men with type 2 DM （ DM group） and 97 men without DM（ NDM group） were scanned with dual - energy X - ray absorptiometry （DEXA） for examination of L1-4 normotopia,left femur BMD,whole body BMD and body composition. The results were analyzed and compared between the two groups. Results （ 1 ） All examined sites had no significant differences in BMD between the two groups, but fat tissue mass （FTM） of whole body, trunk and left leg as well as lean tissues mass （LTM） of left leg in DM group were significant lower than those in NDM group. （2） In DM group, body weight was positively correlated with BMD of lumbar spine, left femur and whole body; body mass index （BMI） was positively correlated with BMD of whole body and left femur （ except wards ＂s triangle area） ;FI＇M of whole body was positively correlated with the BMD of Ll, L3 and whole body; LTM of left leg was positively correlated with BMD of L2, L3, neck of femur, shaft of femur and whole body. （3） In NDM group, body weight, BMI, fat and muscle tissue of various parts of the body were positively correlated with BMD of whole body, respectively. Body weight, BMI, whole body I^FM and trunk FI＇M were positively correlated with BMD of Lt . 4 and left femur, respectively. LTM of whole body was positively correlated with BMD of left femur （except wardst triangle area） and Ll. LTM of left leg was also positively correlated with BMD of each femoral part;LTM of trunk was positively correlated with BMD of left femur neck. Conclusion Decreased FFM and LTM of left leg are the main changes of body composition in male patients with DM. Body composition and BMD in DM men are of certain correlations that are different from those without DM. These differences may be related to metabolic disorders induced by DM.