门诊老年男性2型糖尿病患者合并骨质疏松状况调查

A survey of osteoporosis in elderly male outpatients with type 2 diabetes mellitus

目的调查门诊老年男性2型糖尿病患者中骨质疏松的患病率,并分析2型糖尿病患者发生骨质疏松的有关因素。方法选取2016年6月~2017年6月在解放军总医院第二医学中心体检的老年男性2型糖尿病患者205例(包括既往已诊断骨质疏松9例,未诊断骨质疏松196例)。196例患者再根据骨密度测定分成骨量正常97例,骨量减低43例,骨质疏松56例。计算糖尿病患者中骨质疏松的患病率,比较这3组患者的年龄、病程、收缩压、体质量指数、血钙、血磷、碱性磷酸酶、合并用药、甲状旁腺激素、25(OH)D、骨钙素、1型前胶原氨基端前肽、β-胶原降解产物、左股骨颈骨密度、空腹及餐后血糖、糖化血红蛋白、血脂指标,并采用相关性分析及logistic回归分析其与发生骨质疏松的相关性。结果205例门诊老年男性2型糖尿病患者中骨质疏松的患病率为31.7%,骨质疏松组患者的年龄大、病程长、体质量指数低、血糖高、噻唑烷二酮类及质子泵抑制剂使用率高,3组间比较差异有统计学意义(P<0.05)。相关及回归分析显示老年男性糖尿病患者发生骨质疏松与年龄、糖尿病病程、体质量指数、糖化血红蛋白、噻唑烷二酮类、质子泵抑制剂明显相关(P<0.05)。结论高龄、低体质量、较长的糖尿病病程、较高的糖化血红蛋白、使用噻唑烷二酮类、质子泵抑制剂等可能会增加老年男性2型糖尿病患者发生骨质疏松症的风险。

Objective To investigate the prevalence of osteoporosis in elderly male outpatients with type 2 diabetic,and analyze the related factors of type 2 diabetic patients with osteoporosis.Methods Dividing the 196 elderly male type 2 diabetes patients into three groups,97 cases with normal BMD,43 cases with osteopenia,56 cases with osteoporosis were included.Calculating the prevalence of osteoporosis in type 2 diabetes,and comparing the differences of major clinical factors between the three groups.The correlation of these factors and osteoporosis was analyzed by logistic regression analysis.Results The prevalence of osteoporosis in elderly male diabetes outpatients was 31.7%.The patients with osteoporosis have advanced age,longer course of disease,lower BMI,higher HbA1c.There was a statistical significance between the three groups(P<0.05).Logistic regression analysis showed that age,course of disease,BMI,HbA1c,TZDs and PPIs were related with osteoporosis.Conclusion The advanced age,longer course of disease,lower BMI,higher HbA1c,TZDs and PPIs may increase the risk of osteoporosis in elderly male patients with type 2 diabetes.