绝经后2型糖尿病病人血糖波动与骨密度之间的相关性

Relationship of glycemic variability with bone mineral density in postmenopausal patients with type 2 diabetes mellitus

目的本研究旨在探讨T2DM病人血糖波动与骨密度(BMD)之间的相关性。方法纳入88例绝经后女性T2DM病人为研究对象,入组病人均佩戴扫描式葡萄糖监测(FGM)仪器,并统计其生成的血糖波动指标,包括平均血糖(MBG)、目标范围内时间(TIR)、血糖标准差(SD)、血糖变异系数(CV)、平均血糖波动幅度(MAGE),分析T2DM病人BMD与生化指标、血糖波动指标之间的关系。结果随着BMD水平降低,病人年龄、病程、HbA1c、MBG、SD、CV、MAGE呈逐渐增加,BMI、25-羟维生素D3[25(OH)D3]和TIR水平逐渐降低,差异有统计学意义(P均<0.05)。Pearson相关分析显示,HbA1c、SD、CV、MAGE与BMD呈负相关(r=-0.251、-0.317、-0.317、-0.288,P均<0.05),BMD与TIR呈正相关(r=0.391,P<0.001)。多元线性回归分析显示,TIR为BMD的影响因素(P<0.05)。结论绝经后T2DM病人BMD水平与血糖波动指标存在相关性,低TIR可能是T2DM病人BMD降低的重要危险因素,减少血糖波动有助于延缓老年病人骨量下降。

Objective To investigate the relationship of glycemic variability with bone mineral density(BMD)in the postmenopausal patients with type 2 diabetes mellitus(T2DM).Methods A total of 88 postmenopausal patients with T2DM were enrolled.All the patients accepted the detect of the flash glucose monitoring(FGM),and the mean blood glucose(MBG),the time in range(TIR),plasma glucose standard deviation(SD),glucose coefficient of variation(CV),and the mean amplitude of glycemic excursions(MAGE)were observed.Correlation between the biochemical indicator,glycemic variability and BMD was analyzed.Results With the decrease of BMD,the age,course of disease,glycosylated hemoglobin(HbA1c),SD,CV,MAGE were gradually increased,and body mass index(BMI),25(OH)D3 and TIR were decreased,with statistically significant(P<0.05).Pearson correlation analysis showed that HbA1c,SD,CV and MAGE were negatively correlated with BMD(r=-0.251,-0.317,-0.317,-0.288,all P<0.05),while BMD was positively correlated with TIR(r=0.391,P<0.001).Further,multiple linear regression analysis showed that TIR was a relevant factor of BMD(P<0.05).Conclusions Glycemic variability is related to BMD in the postmenopausal patients with T2DM,and TIR is independently and positively associated with BMD.Reducing glycemic variability may help delay the decline of bone mass.