老年男性2型糖尿病患者双下肢微循环病变与骨质疏松的相关性

The correlation between lower limp microcirculation disease and osteoporosis in elderly male patients with type 2 diabetes

目的探讨老年男性2型糖尿病患者双下肢微循环病变与骨质疏松的相关性。方法选取我院老年病科住院的老年男性2型糖尿病患者120例,通过足背基线值TcpO2分为3组:正常组(A组):足背基线值TcpO2>40 mmHg;轻度异常组(B组):20 mmHg<足背基线值TcpO2<40 mmHg;重度异常组(C组):足背基线值TcpO2<20 mmHg;其中A组42例,B组42例,C组36例,记录年龄、病程、体质量指数(BMI)、血钙(Ca)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C),通过我院无创经皮氧分压测定足背基线值TcpO2,双能X线吸收仪测定腰椎1～5、髋部、股骨颈、股骨转子间的骨密度值。结果与正常组相比,轻度异常组、重度异常组L5、全髋部骨密度均低于正常组,差异有统计学意义(P<0.05);Pearson相关性分析显示,老年男性2型糖尿病患者TcpO2值与L4、L5、全髋部骨密度呈正相关(r=0.254、0.343、0.202),差异有统计学意义(P<0.05)。结论老年男性2型糖尿病患者双下肢微循环病变与骨质疏松存在一定相关性,可能是导致骨质疏松发生的危险因素,及早发现糖尿病下肢微循环病变有助于及早预防骨质疏松疾病。

Objective To investigate the correlation between lower limb microcirculation disease and osteoporosis in elderly male patients with type 2 diabetes. Methods A total of 120 patients hospitalized in the Department of Geriatrics in our hospital were enrolled in the study. The patients were divided into three groups according to the foot back baseline value TcpO2: normal group(A)TcpO2>40 mmHg, mild abnormal group(B) 20 mmHg<TcpO2<40 mmHg, and severe abnormal group (C)TcpO2<20 mmHg. There were 42 cases in group A, 42 cases in group B, and 36 cases in group C. The age, duration of disease, body mass index (BMI), blood calcium (Ca), glycated hemoglobin (HbA1c), and low density lipoprotein cholesterol (LDL-C) were measured. The baseline TcpO2 of the foot was measured with noninvasive percutaneous oxygen pressure in our hospital. bone mineral density (BMD) of L1-5, the hip, the femoral neck, and the intertrochanter was measured with dual energy X-ray absorptiometer. Results BMD of L5 and the total hip in the mild abnormal group and the severe abnormal group was lower than that in the normal group, and the difference was statistically significant ( P <0.05). Pearson correlation analysis showed that the TcpO2 value of the elderly male T2DM patients was positively correlated with BMD of L4, L5, and the total hip ( r =0.254, 0.343, 0.202, P <0.05), and the difference was statistically significant. Conclusion There is a certain correlation between osteoporosis and the lower limbs microcirculation disease, which is a risk factor for the occurrence of osteoporosis. Early detection of the diabetic lower limp microcirculation disease may help to prevent osteoporosis.