绝经后女性不同空腹血糖水平和体质量指数与骨密度的相关性研究

Correlation between fasting blood glucose levels and bone mineral density in postmenopausal women with different levels of body mass index

目的探讨绝经后女性不同空腹血糖水平和体质量指数(bone mass index,BMI)与骨密度的相关性。方法纳入202名绝经后妇女作为受试者,其中42例为2型糖尿病(type 2 diabetes mellitus,T2DM)患者(即T2DM组),160名为非2型糖尿病患者(即健康对照组)。通过双能X射线吸收测定法(DXA)获得其腰椎和股骨颈的骨密度(bone mineral density,BMD)数据,并记录其他相关的临床和实验室数据,分析相关变量之间的相关性。结果 T2DM组的BMD显著高于对照组(P<0. 05);通过空腹血糖和Hb A1c水平比较受试者骨质疏松症的患病率时,发现骨质疏松症的患病率随血糖和Hb A1c升高而显著降低;此外,T2DM组腰椎和股骨颈的BMD明显高于对照组(P<0. 05);同时发现骨质疏松症与糖尿病、BMI和饮酒呈负相关,但与年龄、既往骨折史以及肌肉骨骼系统和结缔组织的其他疾病呈正相关;在调整上述因素后,糖尿病与骨质疏松症之间的关联仍然具有统计学意义(P<0. 05);T2DM与骨质疏松症发病率相关且与BMI不相关(P<0. 05)。结论与健康对照组相比,T2DM患者腰椎和股骨颈的BMD均较高且不受BMI影响。此外,骨质疏松症的患病率随血糖和Hb A1c升高而显著降低。

Objective To explore the correlation between fasting blood glucose levels and bone mineral density in postmenopausal women w ith different levels of body mass index. Methods This study included 202 postmenopausal women as subjects,including42 type 2 diabetes mellitus( T2DM) patients and 160 healthy controls without T2DM. Data on BMD of the lumbar spine and femoral neck were obtained by dual X-ray absorptiometry( DXA),and other relevant clinical and laboratory data were recorded.Results The T2DM group had a higher BMD than the controls( P < 0. 05). When comparing the prevalence of osteoporosis between subjects by glucose and HbA 1c levels,the prevalence of osteoporosis significantly decreased with blood glucose and HbA 1c. In addition,the BMD of the lumbar spine and femoral neck was higher in the T2DM group than in the controls( P<0. 05).Osteoporosis was negatively associated with DM,BMI,and drinking,but positively associated with age,previous fracture history,and other diseases of the musculoskeletal system and connective tissue. The association between diabetes and osteoporosis remained statistically significant after adjusting for the above factors( P<0. 05). T2DM was associated with lower odds of osteoporosis in both obese and non-obese subjects( P<0. 05). Conclusion Compared with healthy subjects,T2DM patients have higher BMD at the lumbar spine and femoral neck,which was not affected by BMI. In addition,the prevalence of osteoporosis significantly decreased with increasing blood glucose and HbA 1c.