中老年男性2型糖尿病患者不同年龄段的骨代谢情况

The Bone Metabolism of Middle-aged and Elderly Men with Type 2 Diabetes at Different Ages

目的:探讨中老年男性2型糖尿病患者不同年龄段的骨代谢的情况。方法:选取中老年男性2型糖尿病患者203人,按年龄分为50-59岁组(A组)、60-69岁组(B组)、70-80岁组(C组),测定各组的身体质量指数(BMI)、腰围(WC)、收缩压(SDP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HD L-c)、骨钙素(OC)、Ⅰ型前胶原氨基末端前肽(P1NP)、Ⅰ型胶原交联C-末端肽(CTX)和骨密度(BMD)。结果:C组的OC、P1NP低于A组、B组,CTX高于A组、B组,C组的病程长于A组、B组,B组的病程长于A组,B、C组股骨颈的BMD值低于A组,C组L4的BMD值高于A、B组,P均<0.05。3组的HbA1c、BMI、股骨干、全髋、L1、L2、L3的BMD值无统计学差异(P>0.05)。相关分析显示:年龄与糖尿病病程(r=0.284,P<0.001)、BMI成正相关(r=0.193,P=0.007);OC与P1NP正相关(r=0.465,P<0.001),与CTX(r=-0.312,P=0.002)、糖尿病病程(r=-0.264,P<0.001)、BMI(r=-0.425,P<0.001)负相关;P1NP与CTX(r=-0.341,P<0.001)、糖尿病病程(r=-0.206,P=0.004)、BMI(r=-0.468,P<0.001)负相关;CTX与糖尿病病程(r=0.171,P=0.017)、BMI(r=0.443,P<0.001)正相关。结论:中老年男性2型糖尿病患者中,骨代谢指标与BMI、糖尿病病程相关,与年龄关系不明显。

Objective: To investigate the bone metabolism of middle-aged and elderly men with type 2 diabetes at different ages.Methods: 203 middle-aged and elderly male patients with type 2 diabetes were recruited and divided into three groups: 50 ≤group A<60, 60≤group B<70, 70≤group C≤80. Anthropometric measurements include: BMI, WC, SDP, DBP, HbA1c, FPG, TG, HDL-c, OC,P1NP, CTX, BMD. Results: OC and P1NP of group C were decreased than group A and group B, While CTX of group C was increased than group A and group B. The diabetes duration of group C was longer than group A and group B, while the diabetes duration of group B was longer than group A. BMD of femoral neck in group B and group C were decreased than group A. BMD of L4 in group C was decreased than group A and group B(P<0.05). HbA1c and BMD values of femoral neck, femoral shaft, total hip, L1, L2, L3 and L4 were not significantly different among the three groups(P>0.05). Correlation analysis showed that age was positively correlated with duration of diabetes(R=0.284, P<0.001) and BMI(R=0.193, P=0.007). OC was positively correlated with P1NP(R=0.465, P<0.001), negatively correlated with CTX(R=-0.312, P=0.002), duration of diabetes(R=-0.264, P<0.001), BMI(R=-0.425, P<0.001). P1NP was negatively correlated with CTX(R=-0.341, P< 0.001), duration of diabetes(R=-0.206, P=0.004), BMI(R=-0.468, P<0.001). CTX was positively correlated with the duration of diabetes(R=0.171, P=0.017) and BMI(R=0.443, P<0.001). Conclusion: In middle-aged and elderly male patients with type 2 diabetes, bone metabolism indexes are correlated with BMI and diabetes course, but not with age.