老年2型糖尿病患者并发骨质疏松的相关因素研究

Relative Factors Analysis of Elderly Type 2 Diabetes Mellitus Complicated with Osteoporosis

目的:探讨老年2型糖尿病(T2DM)患者并发骨质疏松的相关因素,为临床防治糖尿病并发骨质疏松提供理论依据。方法:根据老年T2DM患者的骨密度值将72例患者分为骨质疏松组(OP组)和非骨质疏松组(NOP组),OP组38例,NOP组34例。比较两组老年T2DM患者的体重指数(BMI)、糖尿病病程、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(Fins)、胰岛素敏感指数(ISI)、尿白蛋白定量(ALb)、24h尿蛋白定量和碱性磷酸酶(ALP)等指标之间的差异,并进行相关性分析。结果:OP组患者比NOP的病程长,体重指数低,骨密度低,碱性磷酸酶高,胰岛素敏感指数低,糖化血红蛋白高、空腹胰岛素低、24h尿蛋白定量和尿白蛋白定量高,P<0.05;老年T2DM患者的骨密度与病程、糖化血红蛋白、24h尿蛋白定量、ALb、ALP负相关,与BMI、ISI正相关。结论:低体重、病程长、血糖控制不良、胰岛功能差、胰岛素抵抗、血碱性磷酸酶偏高、糖尿病肾病都是老年T2DM合并骨质疏松的相关因素。

Objective：To investigate the relative factors in elderly patients with type 2 Diabetes Mellitus （E-T2DM）complicated with osteoporosis（OP）and analyze the factors related to diabetic osteoporosis（DOP）so as to provide theoretical evidence for early diagnosis and prevention of osteoporosis complicated with E-T2DM.Methods：According to their bone mineral density（BMD） values,72 elderly patients were divided into OP group（n=38） and non-OP gruup（n=34）.Then we compared differences in body mass index （BMI）,diabetes duration,fasting plasma glucose （FPG）,glycosylated hemoglobin（HbAlc）,fasting insulin （Fins）,insulin sensitivity index（ISl）,quantitative of urinary albumin（ALb）,quantitative of urinary protein in 24 hours and alkaliphosphatase level（ALP）.Rcsults：Compared with those in non-OP group,patients in OP group had longer disease course,smaller baric index,lower bone density, higher alkaliphosphatase,lower insulin sensitivity index,higher glycosylated hemoglobin,higher quantitative of urinary protein in 24 hours and urinary microprotein,which were significantly different according to t-test（P〈0.05）.BMD of elderly type 2 Diabetes Mellitus was negatively correlated to disease course,glycosylated hemoglobin.quantitative of urinary protein in 24 hours,ALb and ALP, but positively correlated to BMI and ISI.Conelusion：Many factors,such as low body weight,long duration of the disease,high level of blood sugar, insulin dysfunction,low insulin sensitivity,high serum alkaline phosphatase and diabetic nephropathy, contributed to osteoporosis in E-T2DM.