定量CT骨密度测定在老年男性糖代谢异常患者中的应用研究

Application of quantitative CT-based measurement of bone mineral density in elderly male abnormal glycometabolism patients

目的探讨定量CT(QCT)骨密度测定在老年男性糖代谢异常患者中的应用价值。方法收集2017年8月~2018年8月解放军总医院第二医学中心常规体检的老年男性138例,根据糖代谢状态分为正常血糖组46例,糖调节受损组44例,糖尿病组48例。所有受试者进行血清学指标检测、QCT骨密度测定。结果糖尿病组体质量指数明显高于正常血糖组[(25.25±3.46)kg/m^2vs(23.76±2.70)kg/m^2,P<0.05]。正常血糖组、糖调节受损组和糖尿病组空腹血糖、糖负荷后2 h血糖和糖化血红蛋白水平逐渐升高,差异有统计学意义(P<0.05)。138例患者中,正常骨量42例(30.4%),低骨量69例(50.0%),骨质疏松27例(19.6%)。偏相关分析显示,校正体质量指数后,年龄与骨密度呈负相关(β=-0.510,P=0.000)。二分类logistic回归分析显示,年龄是骨量下降的危险因素(OR=1.107,95%CI:1.045~1.173,P=0.001)。结论老年男性随糖代谢异常的加重,QCT骨密度有下降趋势。在不同糖代谢患者中,骨质疏松和低骨量检出率相似,增龄仍然是骨密度的主要负性影响因素。

Objective To study the application of quantitative CT(QCT)-based measurement of bone mineral density(BMD) in elderly male abnormal glycometabolism patients.Methods One hundred and thirty-eight elderly male patients who underwent physical examination in our hospital from August 2017 to August 2018 were divided into normal glycometabolism group(n=46),impaired glycometabolism group(n=44),DM group(n=48).The patients underwent serological test and QCT-based measurement of BMD.Results The BMI was significantly higher in DM group than in normal glycometabolism group(25.25±3.46 kg/m^2 vs 23.76±2.70 kg/m^2,P<0.05).The serum levels of fasting blood glucose,postprandial 2 h blood glucose and HbA1 c increased gradually in 3 groups(P<0.05).Of the 138 patients included in this study,42(30.4%) were diagnosed with normal bone mass,69(50.0%) were diagnosed with bone loss,and 27(19.6%) were diagnosed with osteoporosis.Partial correlation analysis showed that age was negatively related with BMD(β=-0.510,P=0.000) in different abnormal glycometabolism patients after adjustment for BMI.Binary logistic regression analysis displayed that age was a risk factor for bone loss(OR=1.107,95%CI:1.045-1.173,P=0.001).Conclusion Osteoporosis is aggrevated and QCT-based measurement of BMD shows a reduction trend of BMD in elderly male abnormal glycometabolism patients.The detection rate of bone loss and osteoporosis is similar in different abnormal glycometabolism patients and aging is a major influencing factor of their BMD.