不同性别老年2型糖尿病患者视网膜病变与骨质疏松的相关性研究

Retinopathy and osteoporosis in elderly patients with type 2 diabetes mellitus of different gender

目的探讨不同性别的老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者视网膜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T2DM患者250例,其中老年男性T2DM组132例,老年女性T2DM组118例,通过眼底检查,每组各再分为两组:视网膜病变组DR(+)、非视网膜病变组DR(-),分别记录患者的一般情况、年龄、糖尿病病程、饮酒史、吸烟史、体质量指数(body mass index,BMI),采用化学仪检测空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(HbA1c)、微量蛋白尿、血脂,双能X线吸收仪测定腰椎、股骨颈和全髋骨密度值。结果老年男性T2DM组中校正年龄、BMI、吸烟史、饮酒史等混杂因素后,与DR(-)组相比,DR(+)组腰椎、髋骨、股骨颈骨密度相比差异无统计学意义(P>0.05);老年女性T2DM组中校正年龄、BMI、吸烟史、饮酒史等混杂因素后,与DR(-)组相比,DR(+)组腰椎、髋骨骨密度值偏低,差异有统计学意义(P<0.05)。结论本研究显示不同性别的糖尿病视网膜病变与骨质疏松相关性有差异,老年男性T2DM患者视网膜病变与骨质疏松无明显相关性,而老年女性T2DM患者视网膜病变与骨质疏松存在一定相关性,积极预防老年女性糖尿病视网膜病变可能在延缓骨质疏松发生发展中起到一定作用。

Objective To investigate the correlation between retinopathy and osteoporosis in elderly patients with type 2 diabetes mellitus(T2DM)of different gender.Methods 250 patients with type 2 diabetes mellitus(T2DM)hospitalized in the department of endocrinology of our hospital were selected,including 132 males and 118 females.After fundus examination,each group was divided into two groups:retinopathy group as DR(+)and non-retinopathy group as DR(-).General information,age,course of diabetes mellitus,history of drinking,smoking and body mass index(BMI)were recorded respectively.Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),microalbuminuria and blood lipids were measured by chemical instrument.Bone mineral density of lumbar spine,femoral neck and total hip were measured by dual energy X-ray absorptiometry densitometer.Results In male T2DM group,after adjusting for age,body mass index,smoking history and drinking history,compared with DR(-)the diabetic non-retinopathy group,bone mineral density of lumbar spine,hip bone and femoral neck in the diabetic retinopathy group was not significanly different(P>0.05).In female T2DM group,after adjusting for age,body mass index,smoking history and drinking history,compared with DR(-)the diabetic non-retinopathy group,bone mineral density of lumbar spine and hip in the diabetic retinopathy group was lower(P<0.05).Conclusion There was no significant correlation between retinopathy and osteoporosis in male patients with type 2 diabetes mellitus,but there was a certain correlation between retinopathy and osteoporosis in female patients with type 2 diabetes mellitus.So proactive prevention of diabetic retinopathy in elderly women may play a role in slowing the development of osteoporosis.