2型糖尿病发生骨质疏松与NLR、RDW、MPV、UA、TBIL相关性研究

Relationship between levels of NLR,RDW,MPV,UA,TBIL and osteoporosis in patients with type 2 diabetes

目的探讨2型糖尿病患者发生骨质疏松与外周血中中性粒细胞/淋巴细胞(NLR)、红细胞分布宽度(RDW)、血小板平均分布宽度(MPV)、尿酸(UA)、总胆红素(TBIL)水平的相关性。方法选取380例2型糖尿病患者进行骨密度(DEXA)检测,采用腰椎和左髋部两个部位的骨密度值,分为骨量正常组(n=91)、骨量减少组(n=140)以及骨质疏松症组(n=149),记录性别、年龄、身高、体重、收缩压、舒张压、糖尿病病程等相关资料,测量空腹血糖(FBG)、糖化血红蛋白(HbAlc)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、NLR、RDW、MPV、UA、TBIL等指标水平,比较三组间的差异并进行相关性分析。结果年龄、性别、BMI、NLR、RDW、MPV、UA、TBIL在三组间均存在统计学差异(P<0.05),其中年龄、性别、NLR、RDW、MPV、UA与骨质疏松呈正相关,BMI、TBIL与骨质疏松呈负相关,多元Ordinal回归分析显示,年龄、NLR、UA为骨质疏松的危险因素(OR=2.208,1.013,P<0.05),相比于男性,女性发生骨质疏松的风险性更大,同样为其危险因素;BMI、TBIL为骨质疏松的保护性因素(OR=0.470,0.420,P<0.05)。结论年龄、女性、NLR、UA为骨质疏松的危险因素,BMI、TBIL为骨质疏松的保护性因素。

Objective To investigate the relationship between levels of NLR,RDW,MPV,UA,TBIL and osteoporosis in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 380 T2 DM patients underwent dual-energy X-ray absorptiometry(DEXA)to test the bone mineral density(BMD),including lumbar spine and left hip.According to the results,these patients were divided into 3 groups:normal bone mass group(n=91),osteopenia group(n=140)and osteoporosis group(n=149).The parameters such as gender,age,height,weight,systolic pressure,diastolic pressure,duration of T2 DM,body mass index(BMI),etc.were collected.Serum levels of FBG,HbAlc,TG,TC,HDL-C,LDL-C,NLR,RDW,MPV,UA,TBIL were measured.The data with normal distribution was expressed by mean±SD.χ~2 test was used for count data analysis,liner correlation analysis for two variables,and ordinal regression for multi-factor analysis.P<0.05 was considered to be statistically significant.Results There were significant differences among the three groups in gender,age,BMI,NLR,RDW,MPV,UA,and TBIL(P<0.05).Among them,the age,gender,NLR,RDW,MPV and UA were positively correlated,whereas BMI and TBIL were negatively correlated with osteoporosis.Ordinal regression analysis revealed that age,NLR and UA were risk factors for osteoporosis(OR=2.208,1.013,P<0.05).Compared with men,women had a higher risk of osteoporosis and was also considered as a risk factor.BMI and TBIL were considered as protective factors of osteoporosis(OR=0.470,0.420,P<0.05).Conclusion Age,female,NLR,UA are regarded as risk factors of osteoporosis.BMI,TBIL are regarded as protective factors of osteoporosis.