应用双能X线骨密度仪探讨糖尿病性骨质疏松症的影响因素

Study on the influence factors of diabetic osteoporosis using dual-energy X-ray absorptiometry

目的探讨2型糖尿病患者骨质疏松的影响因素。方法选择2011年9月至2013年3月在内分泌科住院的男性2型糖尿病患者209例为糖尿病组,选择同期体检的健康男性103例为对照组,应用双能X线骨密度仪(DXA)进行正位腰椎(L1-L4)及左侧股骨骨密度(BMD)测定,检测糖化血红蛋白(Hb A1C)、空腹血糖(FPG)及空腹C肽(CP),并进行统计学分析。结果糖尿病组骨量减少、骨质疏松发生率分别为14.35%、13.87%,明显高于对照组(P<0.05)。两组检测者随着年龄增加,骨密度均呈下降趋势,50岁以上糖尿病患者腰椎及股骨颈骨密度均明显低于同龄对照组(P<0.05)。糖尿病组骨密度多因素相关性分析显示,糖尿病患者骨密度与年龄、病程、Hb A1C呈显著负相关(P<0.05),而与体重指数(BMI)、空腹C肽(CP)呈显著正相关(P<0.05)。结论 2型糖尿病患者骨量减少及骨质疏松发生率较健康体检者明显升高;高龄、病程长及血糖控制不良是糖尿病患者BMD降低的危险因素。

Objective To investigate the influence factors in osteoporosis patients with type 2 diabetes mellitus. Methods Two hundred and nine male inpatients with type 2 diabetes mellitus in the Department of Endocrinology from September 2011 to March 2013 were enrolled in diabetes group, and 103 healthy males were enrolled in control group. Bone mineral density （BMD） of the lumbar spine （ L1 - L4 ） and the left femur was measured using dual energy X-ray absorptiometry （DEXA）. Glycosylated hemoglobin （HbA1C）, fasting blood glucose （FPG）, and fasting C peptide （CP） were detected and statistically analyzed. Results Bone mass in diabetes patients decreased. The osteoporosis incidence were 14.35% and 13.87%, which were significantly higher than that in control group （ P 〈 0. 05 ）. BMD decreased with age in both group. BMD of lumbar spine and femoral neck was significantly lower in diabetes mellitus patients over 50 years old than those in control group （ P 〈 0. 05 ）. Analysis of related factors of BMD in diabetic group showed that BMD was negatively correlated with diabetes, course of disease, and HbA1C （P 〈 0.05）, but positively correlated with body mass index （BMI） and CP （P 〈 0. 05 ）. Conclusion The incidence of osteopenia and osteoporosis in type 2 diabetes mellitus is significantly higher than that in healthy people. Older age, longer course of disease, and poor control of blood glucose are risk factors for low BMD in patients with diabetes.