新诊断男性2型糖尿病患者骨密度临床分析

Clinical analysis of bone mineral density in newly diagnosed type 2 diabetic male patients

目的研究新诊断男性2型糖尿病患者(T2DM)骨密度改变情况及危险因素。方法应用双能X射线吸收法测定了200例新诊断男性T2DM和200例男性对照组的L2-4、Wards区、股骨颈、大转子骨密度。并记录年龄、体重指数、血糖、胰岛素及糖化血红蛋白(HbAlc)等临床指标进行比较。结果男性T2DM的血糖、糖化血红蛋白显著高于对照组(P<0.001),而BMD较对照组显著降低(P<0.05)。T2DM的骨质疏松检出率明显高于对照者(P<0.05)。线性回归分析显示HbA1c为BMD独立危险因素(P=0.003,OR=2.15,95%可信区间:2.89～3.52)。结论 T2DM的骨密度降低明显,骨质疏松发生率高,加强控制糖尿病。

Objective To investigate the variation and risk factors of bone mineral density（BMD） in newly diagnosed type 2 diabetes mellitus（T2DM） male patients.Methods Dual energy X-ray absorptiometry（DEXA） was used to measure the BMD of lumbar spines（L2-4） and proximal femur in 200 patients with T2DM and 200 cases of normal control.Age,BMI,blood glucose,insulin,and HbAlc were also measured and compared.Results Blood glucose and HbAlc of male patients in the T2DM group were significantly higher than those of controls（P0.001）.BMDs of patients in the T2DM group were significantly lower than that in the control group（P0.05）.The incidence of osteoporosis of patients in the T2DM group was significantly higher than that in the control group（P0.05）.Multiple logistic analyses indicated that HbA1c was independent risk factor for BMD（P=0.003,OR=2.15,95%CI： 2.89-3.52）.Conclusion BMD of T2DM patients significantly decreases.The incidence of osteoporosis of T2DM patients is relatively high.T2DM should be controlled intensively.