男性2型糖尿病患者骨密度变化的影响因素分析

Influential Factors for Bone Mineral Density in Male Patients with Type 2 Diabetes Mellitus

目的探讨男性2型糖尿病(T2DM)患者骨密度(BMD)变化的相关影响因素。方法选取安徽医科大学附属省立医院2017年1月~2019年6月收治的男性2型糖尿病患者464例,双能X线骨密度仪测定研究对象左前臂、左股骨及正位脊柱(L1~L4)的BMD,根据BMD值分为骨密度正常组(193例),骨量减少组(205例)和骨质疏松组(66例),比较各组间临床资料及生化指标的差异。结果与骨密度正常组及骨量减少组比较,骨质疏松组年龄、病程、高密度脂蛋白胆固醇(HDLC)、甘油三酯(TG)和单核细胞绝对值(MONO#)差异均有统计学意义(P<0.05);与骨密度正常组比较,骨质疏松组体质指数(BMI)、外周血白细胞计数差异均有统计学意义(P<0.05)。logistic回归分析显示长病程、低BMI、吸烟指数和高MONO#为骨量下降的危险因素(P<0.05)。结论男性T2DM患者应纠正不正确的生活方式,保持正常体质量和戒烟,以更好地预防骨质疏松的发生。

Objective To explore the influential factors for bone mineral density( BMD) in male patients with type 2 diabetes mellitus( T2 DM). Methods 464 male patients with T2 DM in Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled from January 2017 to June 2019. Dual energy x-ray absorptiometry( DEXA) was used to measure BMD of the left forearm,left femur and lumbar spine( L1 ~ L4). According to the value of BMD,the patients were divided into the normal group( 193 cases),the osteopenia group( 205 cases) and the osteoporosis group( 66 cases). The clinical data and biochemical indicators among the groups were compared. Results Compared with the normal group and the osteopenia group,there were significant differences in the age,disease duration,blood high-density lipoprotein cholesterol( HDL-C) and monocyte absolute value( MONO#)in the osteoporosis group( P < 0. 05). Compared with the normal group,there were significant differences in BMI and peripheral blood white blood cell( WBC) counts in the osteoporosis group( P < 0. 05). Logistic regression analysis showed that long disease duration,low BMI,high smoking index,and high MONO# were risk factors for bone loss in men with T2 DM( P < 0. 05). Conclusion Male patients with T2 DM should correct their unhealthy lifestyle,maintain proper weight and quit smoking in order to prevent the occurrence of osteoporosis.