2型糖尿病合并骨质疏松的相关危险因素分析

Relevant risk factors for type 2 diabetes mellitus complicated with osteoporosis

目的分析2型糖尿病合并骨质疏松的骨密度变化及其糖代谢相关生化指标分析。方法将86例2型糖尿病患者按照骨密度分为单纯2型糖尿病组和2型糖尿病合并骨质疏松组，比较两组空腹血糖（FBG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、病程等，并对以上指标与骨密度进行相关性分析。以93例健康体检者作为健康对照组。结果健康体检者骨质疏松发生率明显低于2型糖尿病患者[28．0％（26／93）比59．3％（51／86）]，差异有统计学意义（P〈0．05）。2型糖尿病合并骨质疏松组（51例）HbA1c、FINS、骨密度、病程与单纯2型糖尿病组（35例）比较差异均有统计学意义[（8．57±2．59）％比（7．26±1．68）％、（13．21±4．73）μU／L比（17．54±5．91）μU/L、（0．764±0．130）g／cm2比（0．993±0．123）g／cm2、（11．4±6．4）年比（8．6±4．7）年，P〈0．05]。2型糖尿病患者的骨密度与病程、HbA1c、FINS呈负相关（r=-0．306，-0．185，-0．269；P〈0．05或〈0．01），而与FBG无相关性（P〉0．05）。结论长期血糖控制不良、体内胰岛素水平低下、病程长是2型糖尿病患者易合并骨质疏松的影响因素。

Objective To analyze the changes of bone mineral density （BMD） and glucose metabolism in patients with type 2 diabetes mellitus （T2DM） complicated with osteoporosis. Methods Eighty-six patients with T2DM were selected. The patients were divided into T2DM complicated with osteoporosis group and simple T2DM group according to the BMD value. The fasting blood glucose （FBG）, fasting insulin （ FINS ）, glycosylated hemoglobin （ HbAlc ） and course of disease were compared between the 2 groups, and the correlation was analyzed between the indexes and BMD. Ninety-three health examination people were selected as health control group. Results The rate of osteoporosis in health examination people was significantly lower than that in T2DM patients [ 28.0% （26/93） vs. 59.3% （51/86） ], there was statistical difference （P 〈 0.05）. There were statistical differences in HbA1c,FINS,BMD,course of disease between T2DM complicated with osteoporosis group （ 51 cases ） and simple T2DM group （ 35 cases ） [ （ 8.57±2.59 ） % vs. （7.26 ±1.68）%, （13.21±4.73） μU/L vs. （17.54±5.91） μU/L, （0.764 ±0.130） g/cm2 vs. （ 0.993± 0.123 ） g/cm2, （ 11.4 ± 6.4 ） years vs. （ 8.6± 4.7 ） years, P 〈 0.05 ]. The B MD in patients with T2DM was negatively correlated with course of disease, HbA1c, FINS （r = -0.306, -0.185, -0.269 ; P 〈 0.05 or 〈 0.01 ）,there was no correlation between BMD with FBG （P 〉 0.05 ）. Conclusion The poor long-term blood glucose control,low insulin level,long course of disease are the risk factors for T2DM complicated with osteoporosis.