2型糖尿病患者合并骨质疏松的影响因素分析

Analysis of influencing factors of osteoporosis in patients with type 2 diabetes mellitus

目的分析2型糖尿病(T2DM)患者合并骨质疏松的影响因素。方法回顾性分析2017年7月至2020年7月安徽医科大学附属巢湖医院内分泌科接诊的100例T2DM患者的临床资料,根据是否合并骨质疏松将其分为T2DM组45例,T2DM合并骨质疏松组55例。比较两组性别、年龄、T2DM病程、体重指数(BMI)、舒张压、收缩压、空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、25-羟维生素D3[25(OH)D3]、甲状旁腺激素(PTH)及骨密度(BMD)水平,采用多因素logistic回归分析T2DM发生骨质疏松的影响因素。结果T2DM合并骨质疏松组T2DM病程、HbA1c、PTH均高于T2DM组,BMI、25(OH)D3、BMD均低于T2DM组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,T2DM病程、HbA1c、PTH水平升高为T2DM合并骨质疏松的独立危险因素(OR>1,P<0.05),BMI、25(OH)D3、BMD水平升高为T2DM合并骨质疏松的保护因素(OR<1,P<0.05)。结论T2DM合并骨质疏松患者的血清25(OH)D3水平明显降低,PTH水平明显升高,均是导致T2DM发生骨质疏松的重要因素。

Objective To analyze the influencing factors of osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 100 patients with T2DM admitted to Department of Endocrinology,Chaohu Hospital Affiliated to Anhui Medical University from July 2017 to July 2020 were retrospectively analyzed.The patients were divided into T2DM group(45 cases)and T2DM with osteoporosis group(55 cases)according to whether the patients were associated with osteoporosis.The gender,age,T2DM duration,body mass index(BMI),diastolic blood pressure,systolic blood pressure,fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin(HbA1c),25-hydroxyvitamin D3(25[OH]D3),parathyroid hormone(PTH),and bone mineral density(BMD)were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of osteoporosis in T2DM.Results The T2DM duration,HbA1c,and PTH in T2DM with osteoporosis group were significantly higher than those in T2DM group,while BMI,25(OH)D3,and BMD were significantly lower than those in T2DM group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that T2DM duration,HbA1c,and PTH level were independent risk factors for T2DM with osteoporosis(OR>1,P<0.05).The increase of BMI,25(OH)D3,and BMD were the protective factors for T2DM with osteoporosis(OR<1,P<0.05).Conclusion Serum 25(OH)D3 level is significantly decreased and PTH level is significantly increased in T2DM patients with osteoporosis,both of which are important risk factors leading to osteoporosis in T2DM patients.