绝经后2型糖尿病患者血清25-羟维生素D水平与骨密度的关系

Relationship between Serum 25-hydroxyvitamin D Level and Bone Mineral Density in Post-menopausal Type 2 Diabetic Patients

目的评估绝经后2型糖尿病患者血清25-羟维生素D(25-hydroxylvitamin D,25OHD)营养状况及其与骨密度(bone mineral density,BMD)的关系。方法选择2018年1月至2019年12月在宁夏回族自治区人民医院住院的绝经后2型糖尿病患者132例,检测血清25OHD水平,根据25OHD水平分组,应用双能X线吸收法测定受试者腰椎1~4、全髋及股骨颈的BMD,比较25OHD正常组、不足组、缺乏组、严重缺乏组间BMD差异。结果在132例绝经后2型糖尿病患者中,血清25OHD平均水平(12.92±10.11)μg·L^(-1),25OHD严重缺乏组72例(54.5%),25OHD缺乏组44例(33.3%),25OHD不足组6例(4.5%),25OHD正常组10例(7.6%)。Pearson相关分析显示:绝经后2型糖尿病患者25OHD水平与BMD无相关性(P>0.05),与碱性磷酸酶(alkaline phosphatase,ALP)、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycated hemoglobin,HbA1c),甲状旁腺激素(parathyroid hormone,PTH)、体质量指数(body mass index,BMI)、尿微量白蛋白(urinary microalbumin,UMA)等呈负相关(P均<0.05)。结论绝经后2型糖尿病患者维生素D缺乏严重,25OHD不是BMD下降的独立危险因素。

Objective To assess the nutritional status of serum 25-hydroxylvitamin D(25OHD)and its relationship with bone mineral density(BMD)in post-menopausal patients with type 2 diabetes. Methods A total of 132 post-menopausal type 2 diabetes patients hospitalized in the People’s Hospital of Ningxia Hui Autonomous Region from January 2018 to December 2019 were selected to detect serum 25OHD levels,grouped according to the 25OHD level,and use the dual energy X-ray absorption method to determine the BMD of lumbar spine 1-4,total hip and femoral neck,compare the bone mineral density difference among 25OHD normal group and insufficient group,lack group,and severe lack group. Results Among the 132 post-menopausal patients with type 2 diabetes,the average level of serum 25OHD was(12.92±10.11)μg·L^(-1),with 72 cases(54.5%)in the 25OHD severely deficient group,44 cases(33.3%)in the 25OHD deficient group,and 6 cases(4.5%)in the 25OHD deficient group,10 cases(7.6%)in the 25OHD normal group. Pearson correlation analysis showed that 25OHD levels in post-menopausal patients with type 2 diabetes had no correlation with bone density(P>0.05),and 25OHD levels was negatively correlated with the alkaline phosphatase(ALP),fasting blood glucose(FBG),glycated hemoglobin(Hb A1 c),parathyroid hormone(PTH),body mass index(BMI)and urinary microalbumin(UMA)(P all<0.05). Conclusion Postmenopausal patients with type 2 diabetes have severe vitamin D deficiency,and 25OHD is not an independent risk factor for bone mineral density decline.