2型糖尿病男性患者的骨密度及其与颈动脉内膜中层厚度的关系

Bone mineral density in male patients with type 2 diabetes mellitusand its relation with carotid intima-media thickness

目的探讨2型糖尿病(T2DM)男性患者的骨密度及其与颈动脉内膜中层厚度(IMT)的关系。方法根据年龄和体质指数进行倾向评分匹配,纳入98例T2DM男性患者(T2DM组)与98例男性体检者(非T2DM组)。测定所有研究对象的股骨颈、腰椎(L 1~L 4)的骨密度和T评分,以及颈动脉IMT。评估T2DM男性患者骨质疏松、骨量减少的发生情况,并分析IMT与不同部位骨密度的关系,以及IMT的影响因素。结果T2DM组股骨颈和腰椎的骨密度、T评分低于非T2DM组(P<0.05)。T2DM患者中,有41例(41.8%)、20例(20.4%)患者存在股骨颈骨质疏松、骨量减少,各有31例(31.6%)、25例(25.5%)患者存在腰椎骨质疏松、骨量减少。股骨颈和腰椎部位,低骨密度组IMT均高于正常骨密度组,而仅腰椎部位低骨密度组体质指数均高于正常骨密度组(均P<0.05)。T2DM男性患者股骨颈和腰椎部位的骨密度及T评分与IMT均呈负相关性(均P<0.05)。体质指数、吸烟史、股骨颈和腰椎的骨密度、T评分均是T2DM男性患者IMT的独立影响因素(均P<0.05)。结论T2DM男性患者骨质疏松症或骨量减少的发生率较高,而骨密度越低颈动脉IMT越高,颈动脉粥样硬化的发生风险越高。

Objective To explore bone mineral density(BMD)in male patients with type 2 diabetes mellitus(T2MD)and its relation with carotid intima-media thickness(IMT).Methods Ninety-eight male patients with T2DM(T2DM group)and 98 males receiving healthy examination(non-T2DM group)were enrolled by using propensity score matching according to age and body mass index.All the subjects underwent measurement of BMD and T-score of femoral neck and lumbar spine(L 1-L 4)as well as carotid IMT.Among male patients with T2DM,the incidence of osteoporosis or osteopenia was assessed,and the relation of IMT with BMD in various regions,as well as the factors influencing IMT,was analyzed.Results The T2MD group possessed lower BMD and T-score in the femoral neck and lumbar spine as compared with the non-T2MD group(P<0.05).Among patients with T2DM,41(41.8%)cases and 20(20.4%)cases suffered from osteoporosis and osteopenia of femoral neck,respectively,and 31(31.6%)cases and 25(25.5%)cases suffered from osteoporosis and osteopenia of lumbar spine,respectively.For femoral neck or lumbar spine,IMT in the low BMD group was higher than that in the normal BMD group,and the lower lumbar BMD group had higher body mass index than the normal BMD group(all P<0.05).BMD and T-score of femoral neck and lumbar spine negatively correlated with IMT in male patients with T2DM(all P<0.05).Body mass index,smoking history,BMD and T-score of femoral neck and lumbar spine were the independent influencing factors of IMT in male patients with T2DM(all P<0.05).Conclusion Male patients with T2MD experience a higher incidence rate of osteoporosis or osteopenia,and carotid IMT raises with the increase of BMD,leading to an increased risk of developing carotid atherosclerosis.