2型糖尿病患者合并骨量减少及骨质疏松症相关影响因素分析

Analysis of factors associated with osteopenia and osteoporosis in hospitalized type 2 diabetes mellitus patients

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并骨量减少及骨质疏松症(osteoporsis,OP)相关影响因素。方法采用双能X线骨密度仪(DXA)测定617例住院T2DM患者股骨颈(N)及腰椎1~4(L1-4)的骨密度(bone mineral density,BMD),按BMD分为骨量正常、骨量减少及骨质疏松组,采用SPSS软件比较各组之间年龄、性别、病程及生化指标之间的差异性,分析T2DM骨密度相关影响因素。结果 OP组及骨量减少组女性比例、年龄均高于骨量正常组(P<0.05),BMI低于骨量正常组(P<0.05)。OP组T2DM病程大于骨量减少组及骨量正常组(P<0.05),FPG、2h PG、糖化血红蛋白低于骨量正常组(P<0.05),空腹C肽水平低于骨量正常组(P<0.05)。血钙低于骨量减少组及骨量正常组(P<0.05),骨量减少组空腹胰岛素水平低于骨量正常组(P<0.05)。将上述结果进行Logistic回归分析结果显示:高龄、低FC-P水平、低Hb A1C、低BMI与T2DM合并骨量减少及OP有相关关系(P<0.05)。结论老龄、低空腹C肽水平、低BMI的2型糖尿病患者易出现骨量减少及骨质疏松症。

Objective To explore the factors related to osteopenia and osteoporosis in hospitalized type 2 diabetes mellitus（ T2DM） patients. Methods Bone mineral density（ BMD） of femoral neck（ FN） and lumbar spine（ L1-4） was measured using dual-energy X-ray absorptiometry（ DXA）. According to the BMD values,patients were divided into the groups of normal bone mass,osteopenia and osteoporosis（ OP）. SPSS software was used to compare the differences in age,gender,disease duration and biochemical indicators among the groups and to analyze the influencing factors of bone mineral density in T2 DM. Results The groups of OP and osteopenia had older age,greater proportion of female,but lower BMI than that of the normal bone mass group（ all P〈0. 05）. Compared with the normal bone mass group,the OP group had longer duration for T2DM（ P〈0. 05）,lower levels of FPG,2 HPG and glycosylated hemoglobin（ P〈0. 05）,and lower fasting c-peptide level（ P〈0. 05）. The osteopenia group had lower fasting insulin level than that of the normal bone mass group（ P〈0. 05）. In the logistic regression analysis,older age,lower FC-P level,lower Hb A1 C and lower BMI were significant predictors of T2 DMcombined with osteopenia and OP（ P〈0. 05）. Conclusion In hospitalized type 2 diabetes patients,the patients with older age,lower fasting c-peptide level and lower BMI are more likely to have osteopenia and osteoporosis.