老年男性2型糖尿病患者骨质疏松调查及与体质量指数、糖化血红蛋白、病程和肾功能关系研究

Investigation of osteoporosis in elderly male patients with type 2 diabetes and its relationship with bmi-hba1c,course of disease and renal function

目的探讨老年男性2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨质疏松发生情况及与体质量指数(bone mass index,BMI)、糖化血红蛋白(hemoglobin A1c,HbA1c)、病程和肾功能的相关性,为其防治提供指导。方法选取我院2016年3月至2018年5月收治的443例老年男性T2DM患者及443名老年男性健康体检者,采用双能X线吸收测定仪检测患者的骨密度(bone mineral density,BMD),统计骨质疏松发生情况;同时测定T2DM患者的BMI、HbA1c、病程和肾功能情况。采用单因素和Logistic多元回归分析探讨年龄、病程、BMI、HbA1c和肾功能指标与老年男性T2DM患者发生骨质疏松的相关性。结果443例老年男性T2DM患者中并发骨质疏松有182例,发生率为41.08%,明显高于健康体检者的12.87%(P<0.05);骨质疏松患者年龄、病程、HbA1c、血清胱抑素C(cystatin C,Cys C)、血清尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr)、尿微量白蛋白(urine microalbumin,U-mAlb)均显著高于非骨质疏松患者(P<0.05),BMI明显低于非骨质疏松患者(P<0.05)。Logistic多元回归分析显示,老年男性T2DM发生骨质疏松与年龄、病程、HbA1c、Cys C、BUN、Cr、U-mAlb呈显著正相关关系(P<0.05),而与BMI呈显著负相关关系(P<0.05)。结论老年男性T2DM患者骨质疏松发生率明显升高;高龄、长病程、低BMI、血糖控制不佳及肾功能损伤者更易罹患骨质疏松。

Objective To investigate the incidence of osteoporosis in elderly male patients with type 2 diabetes mellitus(T2DM)and the relationship between osteoporosis and BMI-HbA1c,course of disease and renal function in order to provide guidance for the prevention and treatment of osteoporosis.Methods From March 2016 to May 2018,443 elderly male patients with T2DM and 443 healthy controls were enrolled in our hospital.Bone mineral density(BMD)was measured by dual energy X-ray absorptiometry for the diagnosis of osteoporosis.At the same time,BMI,HbA1c,course of disease and renal function of T2DM patients were measured.Univariate and multivariate logistic regression analyses were used to explore the correlation between age,course of disease,BMI,HbA1c and renal function and osteoporosis in elderly male patients with T2DM.Results In 443 elderly male patients with T2DM,182 cases were complicated with osteoporosis,the incidence rate was 41.08%,which was significantly higher than that in healthy controls(12.87%)(P<0.05).Age,course of disease,HbA1c,Cys C,BUN,SCr and U-mAlb in osteoporosis group were significantly higher than those in non-osteoporosis group(P<0.05),and their BMI was significantly lower than that of non-osteoporosis group(P<0.05).Logistic multiple regression analysis showed that osteoporosis was positively correlated with age,course of disease,HbA1c,Cys C,BUN,Cr,U-mAlb,but negatively correlated with BMI(P<0.05).Conclusion The incidence of osteoporosis in elderly male patients with T2DM was significantly increased.Advanced age,long course of disease,low BMI,and patients with poor blood sugar control and kidney function are more likely to suffer from osteoporosis.