赤峰地区2型糖尿病患者与骨质疏松相关因素分析

Analysis of Factors Related to Type 2 Diabetes and Osteoporosis in Chifeng Area

目的探讨2型糖尿病患者25羟维生素水平及与骨质疏松的相关因素。方法回顾性分析2型糖尿病患者409例,采用美国双能X线骨密度仪测量患者骨密度,同时化验血清25羟维生素D、全段甲状旁腺激素、糖化血红蛋白、血脂等。采用SPSS软件分析之间的相关性。结果组间比较t检验及卡方检验结果显示,患者年龄、性别、BMI、吸烟、饮酒、高密度脂蛋白胆固醇、碱性磷酸酶在骨量正常、骨量减少、骨质疏松三组间差异显著。其中甲状旁腺激素在骨量正常及骨量减少组间有差异。25羟维生素D水平在各组间差异不显著。相关分析显示年龄与各部位骨密度呈显著负相关(P<0.01);BMI与各部位骨密度呈显著正相关(P<0.01);ALP与各部位骨密度呈负相关(其中左股骨P<0.05,其它P<0.01);糖尿病病程与左股骨、大粗隆及全部BMD呈负相关(r=-0.115,r=-0.123,r=-0.103,P<0.05);糖化血红蛋白与左股骨、大粗隆骨密度呈负相关(r=-0.101,r=-0.125,P<0.05);甘油三脂与腰及全部BMD呈正相关(r=0.104,r=0.116,P<0.05),高密度脂蛋白胆固醇与腰椎骨密度呈显著负相关(P<0.01);总胆固醇、低密度脂蛋白、PTH、维生素D与各部位骨密度均无相关性。多元回归分析显示年龄、BMI是影响骨质疏松的主要因素。结论2型糖尿病患者随着年龄增长骨质疏松风险增加,低体重指数更易患骨质疏松。2型糖尿病患者普遍存在维生素D缺乏及不足。

Objective To investigate the levels of 25 hydroxyvitamin and the related factors of osteoporosis in type 2 diabetes patients.Method A retrospective analysis of 409 patients with type 2 diabetes mellitus,Bone density was measured by American dual-energy X-ray absorptiometry.Meanwhile,serum25 hydroxyvitamin D,parathyroid hormone,HbAIc.and blood lipid were tested.SPSS software was used to analyze the correlation.Results The results of T test and chi square test showed that there were significant differences among the three groups in the age, gender,BMI,smoking,drinking,high-density lipoprotein cholesterol and alkaline phosphatase in the three groups: normal bone mass,reduced bone mass and osteoporosis.Parathyroid hormone was found to be different between normal and reduced bone mass groups. 25-hydroxyvitamin D levels were not significantly different among groups.Correlation analysis showed that there was a significant negative correlation between age and bone mineral density(P<0. 01).BMI showed a significant positive correlation with bone mineral density of each site(P<0.01).ALP was negatively correlated with BMD at all sites(among which,left femur P<0.05,others P<0.01).The course of diabetes was negatively correlated with the BMD of the left femur,greater trombone and all BMD(r=-0.115,r=-0.123,r=- 0.103,P<0.05).HbA1c was negatively correlated with BMD of left femur and greater trochanter(r=-0.101,r=- 0.125,P<0.05).Triglycerides were positively correlated with lumbar 2 and total BMD(r=0.104,r=0.116,P<0. 05).There was a significant negative correlation between high-density lipoprotein cholesterol and lumbar vertebra density(P<0.01).There was no correlation between total cholesterol,low-density lipoprotein,PTH and 25-hydroxyvitamin D and BMD of all sites.Multiple regression analysis showed that age and BMI were the main factors affecting osteoporosis.Conclusion People with type 2 diabetes have an increased risk of osteoporosis with age,and a lower bmi is more likely to develop osteoporosis.Vitamin D lack and deficiency are common in people with type 2 diabetes.