老年2型糖尿病合并骨质疏松症132例临床分析

Analysis of Clinical Characteristics of 132 Cases With Type 2 Diabetes Mellitus With Osteoporosis in the Elderly

目的分析老年2型糖尿病(type 2 diabetes mellitus,DM)合并骨质疏松(Osteoporosis)患者的临床特征,探讨老年2型糖尿病患者骨质疏松的危险因素及与骨质疏松的关系。方法选取2013年2月—2015年6月住院年龄大于55岁诊断糖尿病的患者为观察对象,依据骨密度(bone mineral density,BMD)分为两组:记录并统计两组年龄、糖尿病病程、身高、体质量、身体质量指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素水平(fasting insulin,FINS)、糖化血红蛋白(glycosylated hemoglobin,HbA_1C)、胆固醇(cholesterol)、低密度脂蛋白(low density lipoprotein,LDL)、血钙(calcium)、血磷(phosphorus)、碱性磷酸酶(serum alkaline phosphatase,ALP)。结果骨质疏松组年龄大、病程长、糖化血红蛋白高,而BMI、FINS低,胆固醇(CHOL)水平高,差异有统计学意义(P<0.05);相关性分析显示:患者骨密度与年龄、病程、ALP、HbA_1C、CHOL呈负相关,与BMI、FINS呈正相关。结论老年2型糖尿病患者的病程、年龄、BMI为骨质疏松的危险因素,存在糖脂代谢紊乱者并发骨质疏松、导致骨折风险高。

Objective To explore the clinical characteristics of type 2 diabetes mellitus, DM with Osteoporosis in elderly patients,and investigate the correlation between DM and osteoporosis. Methods From February 2013 to June 2015, the patients aged over 55 years with DM were enrolled in the study, According to T value all patients were divided into two groups. Inquired about the history of DM in detail. The height, body weight were measured, and the body mass index （BM1） was calculated. Fasting plasma glucose （FPG）, fasting insulin （FINS）, glycosylated hemoglobin （HbAIC）, cholesterol, low density lipoprotein, calcium, phosphorus and serum alkaline phosphatase were determined. Results The age of patients in the osteoporosis group was significant older than that in the non-osteoporosis group. BM1 of in the osteoporosis group was significant lower than that in the non-osteoporosis groups. And the course of DM in the osteoporosis group was longer. Cholesterol, ALP, and glycosylated hemoglobin levels were higher in osteoporosis group Correlation analysis showed that BMD was positively correlated with BMI level and FINS level. But negatively correlated with age, the history of DM and the levels of ALP, HbA1C, Cholesterol. Conclusion Older age lower BMI and longer disease course are the important risk factors for osteoporosis in elderly with type 2 diabetes. It have high risk of osteoporosis and fracture of patients with disorders of lipid metabolism.