绝经后2型糖尿病患者下肢动脉硬化与骨密度的相关性探讨

The association between arteriosclerosis of the lower extremities and bone mineral density in postmenopausal women with type 2 diabetes

目的探讨绝经后2型糖尿病患者下肢动脉硬化与骨密度及其影响因素的相关性。方法选择正常BMI的绝经后2型糖尿病患者109例,测定踝肱指数(ABI)并进行下肢动脉彩超检查,同时测量脊柱(L1～4)和股骨颈(Neck)的骨密度(BMD),以ABI大小分为外周动脉疾病(PAD)组和非外周动脉疾病组。结果 PAD组的Neck的骨密度值为(0.5999±0.1175)g/cm2,低于非PAD组(0.6909±0.1242)g/cm2,差异有统计学意义(P<0.01);而PAD组内,轻、重症两组间Neck骨密度仍存在统计学差异(P<0.01)。PAD组与非PAD组年龄、糖尿病病程、BMI、脊柱骨密度无统计学差异。PAD组患者较非PAD组收缩压水平升高(P<0.01)。结论绝经后2型糖尿病患者下肢动脉病变与髋部骨质疏松密切相关,二者常同时存在,并可能相互影响,其共同的病理生理机制值得关注。

Objective To explore the association between arteriosclerosis of the lower extremities and bone mineral density（BMD） in postmenopausal women with type 2 diabetes.Methods One hundred and nine postmenopausal women with type 2 diabetes and normal BMI were chosen.Ankle brachial index（ABI） was measured and ultrasound measurement of lower limb artery was conducted.Meanwhile,BMD of lumbar vertebrae 1-4 and the femoral neck were measured.The patients were divided into the peripheral artery disease（PAD） group and non peripheral artery disease（NPAD） group according to the results of ABI.Results BMD of the femoral neck in PAD group（0.5999±0.1175 g/cm2） was lower than that in NPAD group（0.6909±0.1242g/cm2）,and the difference was statistically significant（P0.01）.The difference of BMD of the femoral neck between the mild patients and the severe patients in the PAD group was statistically significant（P0.01）.There were no significant difference of age,the course of diabetes,BMI,and the lumbar BMD between PAD group and NDAP group.The systolic blood pressure of patients in PAD group was higher than that in NDAP group（P0.01）.Conclusion Arteriosclerosis of the lower extremities in postmenopausal women with type 2 diabetes is associated with BMD.They always exist at the same time and affect each other.The common pathophysiological mechanism is worthy to be concerned.