体重指数对男性糖尿病患者身体成份与骨密度关系的影响

The effect of body mass index on relationship between body composition and bone mineral density in men with type 2 diabetes mellitus

目的探讨Ⅱ型糖尿病(DM)患者身体成分与骨密度(BMD)的关系。方法采用双能X线骨密度(BMD)检测仪对125例Ⅱ型DM患者进行腰椎(L1～L4)正位、左髋和全身BMD检测及身体成分检测,按体重指数(BMI)将DM患者分为非肥胖(BMI<25 kg/m2)组(DMNO组)和肥胖(BMI≥25 kg/m2)组(DMO组),分析各组身体成分与BMD的相关性。结果①DMO组所测部位BMD和身体成分质量及脂肪量百分比均显著高于DMNO组,但其所测部位肌肉量百分比显著低于DMNO组。②在DMNO组,左大腿肌肉质量分别与左髋各部(Wards三角除外)BMD,L1、L2、L3BMD等呈显著正相关。全身肌肉质量分别与股骨颈、股骨干、股骨全部、L2 BMD等呈显著正相关。躯干肌肉质量分别与大粗隆和L2 BMD等呈显著正相关。仅全身和躯干脂肪质量均分别与L1 BMD呈显著正相关。③在DMO组,左大腿肌肉质量分别与股骨颈、股骨干和股骨全部BMD等呈显著正相关;而与腰椎BMD无显著正相关。全身脂肪质量分别与L3BMD和L4BMD呈显著正相关,躯干脂肪质量仅与L4BMD呈显著正相关。余无显著相关关系。结论在男性2型DM患者,无论肥胖与否,肌肉质量主要与髋部BMD有明显相关性,脂肪质量只与腰椎BMD明显相关。

Objective To study the relationship between body composition and bone mineral density（BMD） in men with type 2 diabetes mellitus.Methods 125 men with diabetes mellitus（DM） were scanned with dual-energy X-ray absorptiometry（DEXA,GE LUNAR PRODIGY） for L1-L4 of the lumbar spine,left femur,and total body BMD and body composition.According to body mass index（BMI）,all patients were divided into two groups,DM non-Obesity（DMNO）group（BMI25 kg/m2）,and DM Obesity（DMO）group（BMI ≥25 kg/m2）.Results The BMD of the lumbar spine（L1-L4） and left femurs（except Wards triangle） of DMNO were significantly higher than that of DMO.The fat tissue mass（FTM）,percentage of FTM and lean tissues mass（LTM） of whole body,trunk,and left leg were of DMNO were significantly higher than that of DMO.In DMNO group,LTM of left leg was significantly positive correlated with BMD of femoral neck,femoral greater trochanter,femoral shaft,and whole left femur,and BMD of L1,L2 and L3,respectively（P0.01 or P0.05）.LTM of whole body was significantly positive correlated with BMD of femoral neck,femoral shaft,and whole left femur,and BMD of L2,respectively（P0.01 or P0.05）.LTM of trunk was significantly positive correlated with BMD of femoral greater trochanter and L2,respectively（P0.05）.There were significantly positive correlation between LTM of whole body and L1,and between LTM of trunk and L1.In DMO group,LTM of left leg was significantly positive correlated with BMD of femoral neck,femoral shaft,and whole left femur,but was not correlated with BMD of lumbar spine.FTM of whole body was significantly positive correlated with BMD of L3 and L4,respectively（P0.05）.FTM of trunk was significantly positive correlated with BMD of L1.Conclusion LTM of body is more significantly positive correlated with BMD of the left femur than that with BMD of the lumbar spine.FTM of body were only significantly positive correlated with BMD of the lumbar spine in men with type 2 DM.