糖代谢异常的代谢综合征老年男性骨密度及体脂含量特点分析

The feature of bone mineral density and body fat in elderly males with metabolic syndrome of abnormal glucose metabolism

目的探讨糖代谢异常的代谢综合征(MS)患者骨密度(BMD)与体脂百分含量(%fat)的特点。方法随机选取门诊符合标准的老年患者,完成问卷调查、生化、骨代谢相关指标测定,双能X线吸收法测定BMD及%fat。按中国糖尿病学会(Chinese Diabetes Society,CDS)的MS诊断标准,分为MS组与非MS(NMS)组,按WHO骨质疏松(OP)的诊断标准分为骨量正常组,低骨量组及OP组。比较组间差异,分析MS相关危险因素。结果该人群MS患病率为69.03%,,骨质疏松的患病率为7.74%,低骨量患病率为35.48%。MS组骨量正常的百分率高于NMS组,骨质疏松的百分率低于NMS组,P值接近0.05(P=0.06)。MS组各部分%fat均高于NMS组(P<0.01)。在骨量正常、低骨量、OP三组间,年龄逐渐增大(P<0.01),BMI在OP组显著低于其他两组,A区%fat与G区%fat比值(A/G)在正常组显著高于OP组(P<0.01)。Spearman相关分析显示,MS与股骨颈、全髋、腰椎各部位BMD的相关系数分别为0.11、0.13、0.17,但只有腰椎达到统计学差异(P<0.05)。MS与A区%fat,G区%fat,全身%fat以及A/G相关系数分别为0.53,0.33,0.51,0.24,P值均<0.01。logistic逐步回归分析显示,BMI,A区%fat和Cr为MS的独立危险因素。结论该组人群MS以及骨量异常(OP及低骨量)患病率高。MS患者BMD和A区%fat、A/G高于NMS患者,OP患病率低于NMS患者。代表腹部脂肪聚集的A区%fat是MS的独立危险因素。

Objective To explore the characteristics of bone mineral density and body fat in elderly males with metabolic syndrome （MS） of abnormal glucose metabolism. Methods Elderly male patients were randomly selected to conduct the questionnaire, biochemical measurements, and measurement of factors related to bone metabolism. The bone mineral density （BMD） and body fat were measured by dual-energy X-ray absorptiometry. The patients were divided into the MS group and non-MS （NMS） group according to the diagnostic standard of Chinese Diabetes Society, They were also divided into the normal bone mass group, osteopenia group, and osteoporosis （OP） group according to the diagnostic standard of WHO. The differences among these groups were compared and the risk factors for MS were analyzed. Results MS, OP, and osteopenia prevalence in this study were 69.03% , 7.74 % , and 35.48% , respectively. The percentage of normal bone mass in MS group was higher than that in NMS group. The percentage of osteoporosis in MS group was lower than that in NMS group （ P = 0.06）. The percentage of fat of all parts in MS group was higher than that in NMS group （P 〈 0.01 ）. The age gradually increased among normal bone mass, osteopenia, and OP groups （P 〈 0.01 ）. Body mass index （BMI） of patients in OP group was significantly lower than that in the other two groups. The rate of the fat percentage in Android area to Gynoid area （A/G） of patients in normal group was significantly higher than that in the OP group （P 〈 0.01 ）. Theresults of Spearman correlation analysis showed that the correlation coefficients between MS and BMD of the neck of femur, hip, and lumbar were 0. 11, 0.13, and 0.17, respectively, but only the correlation coefficient of lumbar was statistically significant （P 〈 0.05）. The correlation coefficients between MS and the fat percentage of Android area, Gynoid area, total body, and A/G were 0.53, 0.33, 0. 51, and 0.24, respectively （P 〈 0.01 ）. The results of logistic regressive analysis showed that BMI, the fat percentage of Android area, and the creatinine were independent risk factors for MS. Conclusion The prevalence of MS and bone mass abnormality in this group is high. BMD, the fat percent of Android area, and A/G in MS group are higher than those in the NMS group. However, the prevalence of OP in the MS group is lower than that in the NMS group. The fat percentage of Android area as aggregation of abdominal fat is an independent risk factor for MS.