老年2型糖尿病患者血清Toll样受体4与骨质疏松的相关性分析

Correlation between the Level of Serum Toll-like Receptor 4 and Osteoporosis in Older Patients with Type 2 Diabetes Mellitus

目的探讨老年2型糖尿病(T2DM)患者血清Toll样受体4(TLR-4)的表达水平与骨质疏松(OP)的关系。方法选取2018年5月~2019年6月在吉林大学第一医院就诊的T2DM合并OP的老年患者71例(OP组),T2DM无OP的老年患者76例(非OP组),记录所有患者一般情况、病程,计算体质指数(BMI),检测糖化血红蛋白、血糖、血脂、血压等相关指标,用ELISA法检测血清TLR-4水平。比较两组之间的指标差异,用多因素logistic回归对老年T2DM合并OP的危险因素进行分析。结果OP组年龄、女性比例、收缩压、糖化血红蛋白、总胆固醇及血清TLR-4水平均高于对照组(P<0.05),OP组BMI水平低于对照组(P<0.05);多因素logistic回归分析结果显示,年龄、性别、收缩压、总胆固醇及血清TLR-4水平是老年T2DM患者发生OP的危险因素,而BMI是其保护因素,差异均有统计学意义(P<0.05)。结论老年T2DM患者发生OP与女性、年龄、收缩压、总胆固醇及血清TLR-4水平升高,BMI降低密切相关,老年T2DM患者应该密切关注以上指标变化,降低OP发生风险。

Objective To explore the relationship between the level of serum toll-like receptor 4(TLR-4)and osteoporosis in older patients with type 2 diabetes mellitus(T2DM).Methods 71 older patients with T2DM and osteoporosis in the First Affiliated Hospital of Jilin University were assigned into osteoporosis group(OP group)from May 2018 to June 2019,and 76 patients with T2DM but without osteoporosis were assigned into non-osteoporosis group(non-OP group).The general condition,disease course,body mass index(BMI),glycated hemoglobin(HbA1c),blood glucose,blood lipid,blood pressure were documented,and serum TLR-4 level were detected by enzyme-linked immuno-sorbent assay(ELISA).The multivariate logistic regression was used to analyze the risk factors for osteoporosis in older patients with T2DM.Results The age,ratio of female,the levels of systolic blood pressure,HbA1c,total cholesterol,and serum TLR-4 were higher in OP group than those in non-OP group(P<0.05),and BMI was lower in OP group than that in non-OP group(P<0.05).Multivariate logistic regression analysis showed that the age,gender,systolic blood pressure,total cholesterol,and TLR-4 were the risk factors for osteoporosis in older patients with T2DM,and BMI was a protective factor(P<0.05).Conclusion The development of osteoporosis in older patients with T2DM might be closely related to female,age,high systolic blood pressure,high total cholesterol,high serum TLR-4 and low BMI.