2型糖尿病男性患者血尿酸水平与骨质疏松及临床骨折的相关性研究

Correlation between serum uric acid level and osteoporosis and fracture rate in male patients with type 2 diabetes

目的探索2型糖尿病(T2DM)男性患者血尿酸水平与骨密度(BMD)、临床骨折患病率的相关性。方法选取广州市第一人民医院住院的T2DM男性患者192例,采用双能X线骨密度仪测定各部位BMD,记录年龄、糖尿病病程、BMI,检测血尿酸、空腹血糖、糖化血红蛋白、血脂、碱性磷酸酶等,并分析BMD与其余指标的相关性。结果骨质疏松组血尿酸、各部位BMD均低于骨量正常组及低骨量组(P<0.05)。血尿酸与各部位BMD正相关(P<0.01)。右股骨颈BMD与年龄负相关,与空腹血糖正相关(P<0.05)。多元Logistic回归分析显示,血尿酸与临床骨折呈负相关。调整年龄、空腹血糖、ALP等混杂因素后,血尿酸水平与临床骨折仍有关联。当进一步调整各部位BMD时,结果无统计学意义。结论维持正常稍高的血尿酸水平可能有利于减少T2DM男性患者骨质疏松及脆性骨折的发生。

Objective To explore the correlation in serum uric acid level and bone mineral density(BMD)and fracture rate in male patients with type 2 diabetes mellitus(T2DM).Methods 192 cases of male patients with T2DM in Guangzhou First People s Hospital were selected in this study.BMD was measured by bone density machine.The patient s age,diabetes course and BMI were recorded.Fasting blood glucose,glycated hemoglobin(HbA1c),liver and kidney function,blood uric acid,blood lipid,alkaline phosphatase,25 hydroxyvitamin D3 levels were measured,and the correlation between BMD and other indicators was analyzed.Results The serum uric acid level,lumbar and right femoral neck BMD in the osteoporosis group were lower than those in the normal and low bone mass groups(P<0.05).Serum uric acid was positively correlated with BMD values of lumbar spine and right femoral neck in male patients with type 2 diabetes(P<0.01).BMD value of right femoral neck was negatively correlated with age and positively correlated with fasting blood glucose(P<0.05).Multivariate logistic regression analysis showed a significant negative correlation between serum uric acid and clinical fractures in male patients with type 2 diabetes(model 1).When the model was adjusted for age,fasting blood glucose,ALP and other factors,serum uric acid levels were still associated with clinical fractures(model 2).When the BMD values of the lumbar spine and the right femoral neck were further included(model 3),the results were not statistically significant.Conclusion Slightly higher blood uric acid levels may help to reduce the incidence of OP and fracture rate in male patients with T2DM.