2型糖尿病患者骨密度测定及其与糖尿病相关代谢指标的关系

Determination of bone mineral density in patients with type 2 diabetes mellitus and its relationship with diabetes-related metabolic indicators

目的测定2型糖尿病(T2DM)患者骨密度,分析骨密度与糖尿病相关代谢指标之间的关系。方法采用双能X射线骨密度仪检测住院T2DM患者(观察组,322例)和健康体检者(对照组,162例)骨密度,分析T2DM患者骨密度与糖尿病相关代谢指标的相关性。结果观察组左股骨颈、L1～L4椎体骨密度低于对照组(P<0.01)。观察组骨质疏松和骨量减少发生率高于对照组(P<0.05)。T2DM患者左股骨颈骨密度与年龄呈负相关(r=-0.480,P<0.01),与BMI、FBG、HbA1c呈正相关(r=0.331、0.133、0.209,P<0.05或P<0.01);L1～L4椎体骨密度与年龄呈负相关(r=-0.208,P<0.01),与BMI呈正相关(r=0.272,P<0.01)。结论 T2DM患者较健康人更容易发生骨质疏松;糖尿病患者年龄、BMI、FBG和HbA1c水平是骨质疏松发生的影响因素。

Objective To measure the bone mineral density（BMD）in the patients with type 2 diabetes mellitus（T2 DM）and analyze the relationship between BMD and diabetes-related metabolic indicators.Methods The BMD was detected using dual-energy X-ray absorptiometry in T2DM patients（group A,332 cases）and healthy people（group B,162 cases）.The correlation between the diabetes-related metabolic indicators and BMD of different sites of T2 DM patients was analyzed.Results The BMD of the left femoral neck and L1-L4 vertebral bodies in group A was lower than that in group B（P〈0.01）.The incidence of osteoporosis and bone loss in group A was higher than that in group B（P〈0.05）.Pearson correlation analysis showed that in T2 DM patients the BMD of left femoral neck was negatively correlated with the age（r=-0.480,P〈0.01）and positively correlated with the BMI,FBG and HbA1 c（r=0.331,0.133 and 0.209,P〈0.05 or P〈0.01）and the BMD of L1-L4 vertebral bodies was negatively correlated with the age（r=-0.208,P〈0.01）and positively correlated with the BMI（r=0.272,P〈0.01）.Conclusion Compared with healthy people,T2DM patients are more likely to have osteoporosis.The age,BMI,and the levels of FBG and HbA1 care the relevant risk factors for the occurrence of osteoporosis in T2DM patients.