航天职工2型糖尿病并发骨质疏松的相关危险因素

Risk factors for type 2 diabetes mellitus complicated with osteoporosis among aerospace professional staff

目的探讨航天职工2型糖尿病患者合并骨质疏松的危险因素。方法选择航天职工中2型糖尿病患者211例,根据骨密度分为骨质疏松组和非骨质疏松组,对比各组患者年龄、糖尿病病程、体重指数、骨钙素、CTX、25-羟维生素D、甲状旁腺素、空腹血糖、糖化血红蛋白、C肽曲线下面积、HOMA-β、HOMA-CR、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇的差异,并进行Logistic回归分析。结果单因素分析:骨质疏松组和非骨质疏松组比较,糖尿病病程、BMI、25(OH) D、Hb A1c、HOMA-β、HOMA-CR差异有统计学意义(P <0. 05)。多因素Logistic回归分析:糖尿病病程(OR=0. 007,95%CI:0. 000～0. 182)、体重指数(OR=8. 888,95%CI:1. 646～47. 998)、糖化血红蛋白(OR=0. 497,95%CI:0. 332～0. 744)、HOMA-β(OR=27. 433,95%CI:8. 105～92. 844)、25-羟维生素D(OR=1. 169,95%CI:1. 047～1. 306)是独立影响因素。结论长糖尿病病程、低体重、高血糖、胰岛功能差、25-羟维生素D缺乏是航天系统职工2型糖尿病合并骨质疏松的危险因素。

Objective To explore the risk factors for type 2 diabetes mellitus( T2 DM) complicated with osteoporosis among aerospace professional staff. Methods Two hundred and eleven T2 DM patients among aerospace professional staff were included in this research. According to the bone mineral density,these patients were divided into the osteoporosis group and non-osteoporosis group. The differences in age,diabetes duration,body mass index,osteocalcin,CTX,25( OH) D,parathyroid hormone,fasting plasma glucose,glycosylated hemoglobin Alc,area under the curve of C-peptide,C peptide secretion index,C peptide resistance index,total cholesterol,triglyceride,high density lipoprotein cholesterol,and low density lipoprotein cholesterol were compared between the two groups. Logistic regression analysis was made. Results Single-factor analysis suggested that there was statistically significant difference between the two groups in terms of the course of disease,body mass index,25( OH) D,Hb A1 c,HOMA-β and HOMA-CR( P < 0. 05). Multivariate Logistic regression analysis indicated that the course of disease( OR = 0. 007,95% CI: 0. 000-0. 182),BMI( OR = 8. 888,95% CI: 1. 646-47. 998),Hb A1 c( OR = 0. 497,95% CI: 0. 332-0. 744),HOMA-β( OR = 27. 433,95% CI: 8. 105-92. 844) and 25( OH) D( OR =1. 169,95% CI: 1. 047-1. 306) were independent risk factors for osteoporosis in patients with T2 DM. Conclusions Long courses of diabetes,low weight,poor glycemic control,bad pancreas islet function and low 25( OH) D are the risk factors for osteoporosis in patients with T2 DM among aerospace professional staff.