2型糖尿病中老年男性患者身体形态指数与骨密度的相关性研究

Study on the Correlation between Body Shape Index and Bone Mineral Density in Middle-aged and Elderly Men with Type 2 Diabetes

目的分析2型糖尿病中老年男性患者身体形态指数与骨密度的关系。方法纳入2018年12月—2020年2月于江苏大学附属医院内分泌科住院的中老年男性2型糖尿病患者148例。采用双能X线吸收测定法(DXA)检测骨密度,从而获得T值,依据T值分为骨量正常组、骨量减少组和骨质疏松组。入组时记录所有研究对象的临床一般资料,检测相关生化指标,如空腹血糖、空腹胰岛素、甘油三酯(TG)、胆固醇(TC)、糖化血红蛋白等。对比3组间的差异,同时剖析中老年男性2型糖尿病患者身体形态指数与骨密度的联系。结果骨质疏松组的收缩压水平及年龄均分别显著高于骨量正常组,甘油三酯水平显著低于骨量减少组及骨量正常组,差异有统计学意义(P<0.05)。骨质疏松组的腰围、腰臀比及体重指数均明显低于其余两组,差异有统计学意义(P<0.05)。骨质疏松组的身体形态指数水平高于骨量正常组及骨量减少组,差异有统计学意义(P<0.05)。身体形态指数与股骨颈及Ward's角呈负相关(r=-0.206,P=0.013;r=-0.212,P=0.010),与腰椎1-4平均骨密度无显著相关性(r=0.035,P=0.673)。结论身体形态指数升高可能增加中老年男性2型糖尿病患者患骨质疏松的风险。希望为临床骨质疏松的防治提供新的思路。

Objective To analyze the relationship between body shape index and bone mineral density in middle-aged and elderly men with type 2 diabetes.Methods 148 middle-aged and elderly male patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,Jiangsu University Affiliated Hospital from December 2018 to February 2020 were included.The dual-energy X-ray absorptiometry(DXA)was used to detect the bone density to obtain the T value.According to the T value,it was divided into a normal bone mass group,an osteopenic group and an osteoporosis group.At the time of enrollment,the general clinical data of all subjects were recorded,and related biochemical indicators were detected,such as fasting blood glucose,fasting insulin,triglycerides(TG),cholesterol(TC),glycosylated hemoglobin,etc.Compared the differences between the three groups,and analyzed the relationship between body shape index and bone mineral density in middle-aged and elderly men with type 2 diabetes.Results The systolic blood pressure level and age of the osteoporosis group were significantly higher than the normal bone mass group,and the triglyceride level was significantly lower than that of the osteopenia group and the normal bone mass group,and the difference was statistically significant(P<0.05).The waist circumference,waist-to-hip ratio and body mass index of the osteoporosis group were significantly lower than those of the other two groups,and the difference was statistically significant(P<0.05).The body shape index level of the osteoporosis group was higher than that of the normal bone mass group and the osteopenia group,and the difference was statistically significant(P<0.05).The body shape index was negatively correlated with femoral neck and Ward’s angle(r=-0.206,P=0.013;r=-0.212,P=0.010),and there was no statistically significant difference correlation with the average bone mineral density of the lumbar spine 1-4(r=-0.035,P=0.673).Conclusion Increased body shape index may increase the risk of osteoporosis in middle-aged and elderly men with type 2 diabetes,hoping to provide new ideas for the prevention and treatment of clinical osteoporosis.