2型糖尿病合并骨质疏松相关因素分析

Relevant factors for type 2 diabetes mellitus complicated by osteoporosis

目的探讨2型糖尿病患者合并骨质疏松的危险因素,为预防和早期诊断糖尿病合并骨质疏松提供依据。方法根据2014年2月-2015年7月茂名市人民医院收治的175例2型糖尿病确诊患者的骨密度值,将患者分为骨质疏松组(OP组)80例和非骨质疏松组(NOP组)95例。比较两组年龄、性别、病程、体重指数(BMI)、血磷、糖化血红蛋白(Hb A1c)、碱性磷酸酶(ALP)等一般资料和生化指标的差异,采用Pearson相关分析对各因素和骨密度的相关性进行分析。结果 OP组骨密度为(0.82±0.17)g/cm,显著低于NOP组(1.25±0.12)g/cm的骨密度值(t=5.862,P<0.01)。OP组年龄[(67.26±11.35)vs.(61.85±10.62)]岁、病程[(10.44±10.13)vs.(7.03±3.45)年]、BMI[(24.38±3.51)vs.(26.82±4.89)kg/m2]、空腹胰岛素[(12.887±5.265)vs.(18.429±6.166)m IU/L]、Hb A1c[(8.23±2.57)vs.(8.23±2.57)%]和ALP[(69.75±23.37)vs.(62.26±20.81)U/L]与NOP组差异有统计学意义(P<0.05)。Pearson相关性分析显示:年龄、病程、Hb A1c、ALP与2型糖尿病合并骨质疏松患者骨密度有负相关关系(r=-0.753、-0.657、-0.587、-0.641、-0.714,P<0.05)。BMI和空腹胰岛素与骨密度存在正相关关系(r=0.626、0.765,P<0.05)。结论高龄、病程长、低体质量、血糖控制差及高ALP和Hb A1c的2型糖尿病患者发生骨质疏松的风险更高,宜给予特殊关注。

Objective To explore the risk factors for type 2 diabetes mellitus patients complicated with osteoporosis so as to provide evidence for prevention and early diagnosis of type 2 diabetes mellitus complicated by osteoporosis.Methods According to their bone mineral density,175 patients with type 2 diabetes mellitus hospitalized in the People＇s Hospital of Maoming City from February 2012 to July 2015 were divided into osteoporosis group（n = 80） and non-osteoporosis group（n = 95）.The clinical data,including age,gender,duration of diabetes,body mass index（BMI）,serum phosphorus,glycosylated hemoglobin 1c（Hb A1c） and alkaline phosphatase（ALP） were compared between the two groups.The correlations between the relevant factors and bone mineral density were analyzed by pearson correlation analysis.Results The bone mineral density was significantly lower in the osteoporosis group than in the non-osteoporosis group（0.82 ± 0.17 g/cm vs.1.25 ± 0.12 g/cm,t = 5.862,P 0.01）.There were statistically significant differences in age（67.26 ± 11.35 vs.61.85 ± 10.62 years old）,duration of diabetes（10.44 ± 10.13 vs.7.03 ± 3.45 years）,BMI（24.38 ± 3.51 vs.26.82 ± 4.89 kg/m2）,fasting insulin（12.887 ± 5.265 vs.18.429 ± 6.166 m IU/L）,Hb A1c（8.84 ± 2.36% vs.8.23 ± 2.57%） and ALP（69.75 ± 23.37 vs.62.26 ± 20.81 U/L） between the two groups（P〈 0.05）.Pearson correlation analysis showed that age,duration of diabetes,Hb A1 c and ALP were negatively correlated with the bone mineral density（r =-0.753,r =-0.657,r =-0.587,r =-0.641,P〈 0.05）,while BMI and fasting insulin were positively correlated with the bone mineral density（r = 0.626,r = 0.765,P〈 0.05）.Conclusions Type2 diabetes mellitus patients with advanced age,longer duration of diabetes,higher BMI,worse blood glucose control,higher ALP and higher Hb A1 c are at higher risk for osteoporosis;and hence,special attention should be paid to them.