老年男性2型糖尿病患者血尿酸与骨密度的相关性分析

Correlation analysis between serum uric acid and bone mineral density in elderly male patients with type 2 diabetes

目的探讨老年男性2型糖尿病患者血尿酸与骨密度的相关性。方法选取2015年1月—2017年12月入住本院内分泌科的老年男性2型糖尿病患者156例,采用双能X线骨密度测定仪测量左侧股骨颈、左髋、腰椎1-4的骨密度,全自动生化仪检测其生化指标、高压液相法检测糖化血红蛋白水平,根据血尿酸水平分成2组:血尿酸正常组(血尿酸<420μmol/L,64例)、血尿酸增高组(血尿酸≥420μmol/L,92例),同时根据骨量T值分成骨量正常组、骨量减低组、骨质疏松组。比较组间各项生化指标及骨密度(MBD)的差异,并分析血尿酸与MBD的相关性。结果 (1)尿酸增高组患者SBP、DBP、TG、LDLC、脂蛋白a、FPG、2h PG、HbA1C等均较尿酸正常组明显升高(P<0.01或P<0.05);(2)与尿酸正常组比较,尿酸增高组患者L_1、L_2、L_3、L_4、L_(1-4)、股骨颈、全髋MBD均明显升高(P<0.05或P<0.01);(3)与骨量正常组比较,骨量减低组、骨质疏松组血尿酸水平均明显降低,且血尿酸与MBD呈明显正相关。(4)Pearson相关分析显示:血尿酸与L_1、L_2、L_3、L_4、L_(1-4)、股骨颈、全髋MBD均呈明显正相关(r分别为0.528、0.604、0.564、0.747、0.669、0.711、0.764,P<0.05或P<0.01)。结论老年男性2型糖尿病患者血尿酸水平与MBD呈明显正相关,监测血尿酸水平有助于骨质疏松症的筛查。

Objective To investigate the correlation between serum uric acid and bone mineral density(BMD） in elderly male patients with type 2 diabetes. Methods There were 156 elderly male patients with type2 diabetes mellitus who were treated in the department of endocrinology in our hospital from January 2015 to December 2017 were selected as subjects for the study. The automatic biochemical detector was used to measure the biochemical indicators(including blood fat,fasting plasma glucose,2 hours plasma glucose and renal function）. Dual energy X-ray bone density absorptiometry(DEXA） was used to measure the BMD of left femoral neck,left total hip and the lumbar(L_1-L_4）. All subjects were divided into the normal uric acid group(n = 64）and the heighten uric acid group(n = 92） according to blood uric acid levels. Then all subjects were divided into3 groups： the normal BMD group(n = 25）,the osteopenia group(n = 84） and the osteoporosis group(n = 47） on the basis of T scores. Contrasted the difference of biochemical indicators and BMD,and analyzed the correlation between serum uric acid and BMD. Results(1） The levels of Systolic blood pressure(SBP）,diastolic blood pressure(DBP）,triglycerides(TG）,low density lipoprotein(LDLC）,lipoprotein a,fasting plasma glucose(FPG）,2 hours plasma glucose(2 h PG）,glycosylated hemoglobin(Hb A1 c） in heighten uric acid group were significantly higher than those in normal uric acid group,and the differences were statistically significant(all P0.01 or P0.05）.(2） Compared with the normal uric acid group,the levels of BMD of the left femoral neck,the left total hip and the lumbar(L1,L2,L3,L4,L1-4） in heighten uric acid group were significantly lower than those in normal uric acid group,and the differences were statistically significant(all P〈0.01 or P〈0.05）.(3）Compared with the normal BMD group,the levels of blood uric acid in the osteopenia group and the osteoporosis group were significantly decreased(both P0.01）,and the levels of blood uric acid was positively correlated with BMD.(4） Single factor correlation analysis results showed that the levels of blood uric acid were positively correlated with BMD of the lumbar(L1,L2,L3,L4,L1-4） left femoral neck and the left total hip(all P0.01 or P0.05）. Conclusions The levels of blood uric acid are positively correlated with BMD in the elderly male patients with type 2 diabetes. Monitoring blood uric acid is helpful to the screening of osteoporosis.