老年男性2型糖尿病合并骨质疏松症患者血浆同型半胱氨酸与骨密度的相关性分析

Correlation between Plasma Homocysteine and Bone Mineral Density in Elderly Male Type 2 Diabetes Patients with Primary Osteoporosis

目的探讨血浆同型半胱氨酸(Hcy)与老年男性2型糖尿病患者指骨骨密度(BMD)的关系。方法 96例老年男性2型糖尿病患者按照指骨BMD分为三组,骨质疏松(A)组30例、低骨量(B)组38例及骨量正常(C)组28例。选取健康对照(D)组26例,分别比较各组BMI、收缩压(SBP)、舒张压(DBP)、血浆三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、HbA1c、Hcy、血钙、血磷及碱性磷酸酶(ALP)水平。结果 A组与B组Hcy的水平明显高于C组与D组,且A组高于B组,C组高于D组(P<0.05);血浆Hcy的水平与指骨BMD呈负相关(r=-0.601,P<0.05);BMI与骨质疏松是Hcy的影响因素(回归系数b1=-2.108,b2=2.787,P<0.05)。结论老年男性2型糖尿病合并骨质疏松症患者高血浆Hcy水平可能与其指骨BMD减低有关,血浆Hcy水平升高可能为老年男性2型糖尿病患者骨质疏松症发病的独立危险因素之一。

Objective To study the relationship between plasma homocysteine（Hcy）and phalangeal bone mineral density（BMD）in elderly male type 2 diabetes patients with primary osteoporosis.Methods 96 elderly male patients with type 2 diabetes were divided into three groups：patients in group A（30 cases）were osteoporosis group,patients in group B（38 cases）were osteopenia group,and patients in group C（28 cases）were normal group.26 additional eligible cases as normal contrast group（D）were chosen.BMI,SBP,DBP,TG,LDL-C,HDL-C,TC,HbA1c,Hcy,blood calcium,and ALP levels were compared among the different groups.Results Levels of plasma Hcy in group A and group B were higher than in group C and group D,and group A was higher than group B,group C was higher than group D（P0.05）.Phalangeal BMD was negatively correlated with plasma Hcy（r=-0.601,P0.05）.BMI and osteoporosis were the risk factors for Hcy（b1=-2.108,b2=2.787,P0.05）.Conclusion Elevated Hcy levels in in elderly male type 2 diabetes patients with primary osteoporosis may be correlated with the decrease of phalangeal BMD.Elevated Hcy levels may be one of potential risk factors for osteoporosis in elderly male type 2 diabetes patients.