2型糖尿病患者绝经后女性骨密度及其影响因素

Bone mineral density in postmenopausal women with type 2 diabetes and its effecting factors

目的研究2型糖尿病患者绝经后女性的骨密度变化及其相关影响因素。方法选取住院治疗的2型糖尿病患者绝经后女性(糖尿病组)42例,绝经后血糖正常女性(对照组)21例。所有研究对象全部进行一般项目、临床资料调查、生化指标测定。双能X线骨密度仪(DXA)测定L1、L2、L3、L4及腰椎前后位总体(L1-4),股骨颈(Neck)、Ward’s三角区、股骨大粗隆、股骨的骨密度值(BMD)。连续性变量以均数±标准差表示,正态分布变量两组间比较采用t检验,多因素分析应用Logistic回归,显著性水准α设置为0.05。结果糖尿病组与对照组的年龄、绝经年龄、绝经年限、BMI、骨密度差异无统计学意义(P>0.05);根据骨密度测量结果,将糖尿病组进一步分为糖尿病组骨质疏松组、糖尿病骨量减少组、糖尿病骨量正常组,糖尿病骨质疏松组骨密度较骨量正常组显著下降(P<0.01);经多因素Logistic回归分析,骨质疏松的发生与年龄独立相关,与BMI独立负相关(P<0.05)。结论 2型糖尿病患者绝经后女性骨密度与绝经后血糖正常女性的骨密度无显著性差异,年龄、BMI是骨质疏松症的独立影响因素。

Objective To evaluate the association between type 2 diabetes and bone mineral density（BMD） and to investigate related factors of osteoporosis in postmenopausal women with type 2 diabetes. Methods A total of 42 postmenopausal women with type 2 diabetes were chosen as study group and 32 healthy non-diabetic postmenopausal women were chosen as controls. Sub- jects were measured some clinical and biochemical indicators. Dual-energy X-ray absorptiometry （DXA） determined the BMD of L1, L2, L3, L4 and lumbar overall（L1-4）, femoral neck, greater trochanter, Ward＇s triangle, femur total. Means of continuous variances between-group compari- sons were performed with mean standard deviation; the normally distributed variables between the two groups were compared using the t test, the multiple stepwise regression analysis was used to analyze its correlations indicators. P〈0.05 was taken as statistically significant. Results There were no significant differences found in age, menopausal age, menopausal duration, BMI, BMD between two groups（P〈0.05）. Logistic regression analysis showed that the morbidity of osteoporosis had an independent positive correIation with age, but an independent negative cor relation with BMI（P〈0.05）. Conclusion There were no significant differences found in BMD be tween postmenopausal women with type 2 diabetes and non-diabetic postmenopausal women. In postm enopausal women with type 2 diabetes age and low BMI are independent factors for osteoporosis.