吸烟对男性2型糖尿病患者骨密度与骨生化指标的影响

Effects of smoking on bone mineral density and bone biochemical indexes of male patients with type 2 diabetes mellitus

目的探讨吸烟对男性2型糖尿病(T2DM)患者骨密度(BMD)与骨生化指标的影响。方法选取我院2017年1月至2019年6月收治的464例男性T2DM患者,按吸烟指数将其分为不吸烟组(194例)、少量吸烟组(142例)和大量吸烟组(128例)。比较三组的一般资料、BMD及骨生化指标。结果大量吸烟组Radius 33%、左股骨颈、左股骨大转子、正位脊柱L1~L3的BMD均低于不吸烟组及少量吸烟组(P<0.05);少量吸烟组及大量吸烟组正位脊柱L4的BMD低于不吸烟组(P<0.05)。少量吸烟组和大量吸烟组的N端骨钙素(N-MID)水平低于不吸烟组(P<0.05);大量吸烟组的总Ⅰ型胶原氨基端延长肽(tPINP)水平低于不吸烟组,β-胶原特殊序列(β-CTx)水平高于不吸烟组(P<0.05)。结论有吸烟习惯的男性T2DM患者的BMD更低,骨生化指标更差。为此,对于男性T2DM患者来说应及早戒烟,以更好地预防骨质疏松症(OP)的发生。

Objective To explore the effects of smoking on bone mineral density(BMD)and bone biochemical indexes of male patients with type 2 diabetes mellitus(T2DM).Methods A total of 464 male patients with T2DM admitted in our hospital from January 2017 to June 2019 were selected.According to smoking index,the patients were divided into nonsmoking group(194 cases),light smoking group(142 cases)and heavy smoking group(128 cases).The general data,BMD and bone biochemical indexes of the three groups were compared.Results The BMD of Radius 33%,left femoral neck,left femoral greater trochanter and orthotopic spine L1~L3 in the heavy smoking group were all lower than those in the non-smoking group and the light smoking group(P<0.05);BMD of the orthotopic spine L4 in the light smoking group and the heavy smoking group was lower than that in the non-smoking group(P<0.05).The level of N-terminal osteocalcin(N-MID)in the light smoking group and heavy smoking group was lower than that in the non-smoking group(P<0.05);the level of total N-terminal propeptide of typeⅠprocollagen(tPINP)in the heavy smoking group was lower than that in the nonsmoking group,the level ofβ-crosslaps(β-CTx)was higher than that in the non-smoking group(P<0.05).Conclusion Male smokers with T2DM have lower BMD and worse bone biochemical indexes.Therefore,male patients with T2DM should quit smoking as soon as possible to better prevent osteoporosis(OP).