住院2型糖尿病男性患者骨质疏松相关危险因素分析

The risk factors related to osteopenia and osteoporosis in male patients with type 2 diabetes in hospitalized

目的分析住院2型糖尿病男性患者发生骨量减少及骨质疏松的相关危险因素。方法选取2018年1月至2020年1月在天津医科大学代谢病医院内分泌科住院的年龄≥50岁的2型糖尿病男性患者370名,排除继发性骨质疏松以及其他影响骨代谢的疾病。应用美国GE公司的LUNAR双能X线骨密度仪测定患者腰椎L1~L4、股骨颈、全髋部位的骨密度,根据骨密度结果分为骨量正常组,骨量减少组与骨质疏松组,比较3组患者的年龄、病程、生化指标、糖尿病并发症等情况,分析引起骨量减少以及骨质疏松的危险因素。应用SPSS 24.0进行统计学分析,P<0.05为差异有统计学意义。结果2型糖尿病合并骨质疏松组男性患者年龄、病程、糖化血红蛋白、TC、LDL-C以及糖尿病微血管及大血管患病率均高于正常骨量与骨量减少组(P<0.05)。而HOMA-β低于骨量正常与骨量减少组(P<0.05),将上述结果进行Logistic回归分析,结果显示,年龄与糖尿病病程的增加、糖化血红蛋白的升高是住院男性2型糖尿病患者发生骨量减少的危险因素。而年龄的增长、糖尿病病程的增加,糖化血红蛋白、低密度脂蛋白的升高、合并微血管与大血管并发症是这些患者发生骨质疏松的危险因素。结论年龄、病程、HbA1c、LDL-C,合并微血管与大血管并发症可以预测住院2型糖尿病男性患者骨质疏松发生风险。

Objective To analyze risk factors of osteopenia and osteoporosis in male patients with type 2 diabetes in hospitalized.Methods We included a total of 370 men with type 2 diabetes who had received DXA and aged above 50 years at Tianjin Metabolic Diseases Hospital between January 2018 to January 2020,excluding secondary osteoporosis and other factors affecting bone metabolism.GE’s LUNAR Prodigy dual-energy X-ray bone density instrument was used to measure the BMD of the lumbar spine 1-4,femoral neck and total hip of those patients.According to the BMD values,patients were divided into the groups of normal bone mass,osteopenia and osteoporosis(OP).Compare the differences in age,disease duration,biochemical indicators,diabetes complications to analyze the influencing factors of bone mineral density in T2DM.SPSS 24.0 statistical software was used for analyzed and P<0.05 was considered statistically significant.Results The groups of OP had older age,longer duration for T2DM,higher levels of glycosylated hemoglobin,TC,LDL-C and more patients suffer from diabetic microvascular and macrovascular complications(P<0.05).The groups of OP had lower HOMA-βlevel(P<0.05).In the logistic regression analysis,older age,longer diabetes duration and higher HbA1c were independent predictors of osteopenia in men with type 2 diabetes in hospitalized.Besides the above factors,the low density lipoprotein cholesterol and combined diabetic microvascular and macrovascular complications were the factors related to the risk of osteoporosis.Conclusion It was found that age,diabetes duration,HbA1c,LDL-C serum and combined diabetic microvascular and macrovascular complications can predict the osteoporosis-risk in men with type 2 diabetes in hospitalized.