老年女性2型糖尿病患者骨密度与肌量变化的相关性

CORRELATION BETWEEN BONE MINERAL DENSITY AND MUSCLE MASS CHANGE IN ELDERLY WOMEN WITH TYPE 2 DIABETES MELLITUS

目的探讨老年女性2型糖尿病(T2DM)患者骨密度(BMD)与肌量变化的相关性。方法回顾性分析2019年1—12月于我院内分泌科住院的158例老年女性T2DM患者的临床资料,根据BMD T值将患者分为3组:BMD正常组(A组)、BMD减低组(B组)和骨质疏松组(C组)。收集所有患者的年龄、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、老年营养风险指数(GNRI)、BMD T值、四肢骨骼肌质量指数(ASMI)等指标,分析BMD与肌量变化的相关性。结果3组患者的年龄、FBG、HOMA-IR以及GNRI比较差异有统计学意义(H=6.992~8.724,F=8.894,P<0.05);3组患者的肌量减少构成比、腰椎BMD T值、左股骨颈BMD T值、BMD最低T值及ASMI比较差异有统计学意义(H=6.182~113.853,χ^(2)=9.540,P<0.05);多元线性回归分析结果显示,年龄与BMD最低T值呈负相关(β=-0.041,t=-2.834,P<0.05),GNRI、ASMI与BMD最低T值呈正相关(β=0.027~0.377,t=2.036~3.715,P<0.05)。结论老年女性T2DM患者BMD减低与增龄、GNRI及肌量减少存在一定相关性。

Objective To investigate the correlation between bone mineral density(BMD)and muscle mass change in elderly women with type 2 diabetes mellitus(T2DM).Methods A retrospective analysis was performed for the clinical data of 158 elderly female patients with T2DM who were hospitalized in Department of Endocrinology in our hospital from January to December,2019,and according to the T-score of BMD,the patients were divided into normal BMD group(group A),reduced BMD group(group B),and osteoporosis group(group C).Related indices were collected to investigate the correlation between BMD and muscle mass change,including age,fasting blood glucose(FBG),Homeostasis Model Assessment of Insulin Resistance(HOMA-IR),geriatric nutritional risk index(GNRI),T-score of BMD,and appendicular skeletal muscle mass index(ASMI).Results There were significant differences in age,FBG,HOMA-IR,and GNRI between the three groups(H=6.992-8.724,F=8.894,P<0.05),and there were also significant differences between the three groups in the ratio of muscle mass loss,T-score of BMD of lumbar vertebra,T-score of BMD of left femoral neck,the lowest T-score of BMD,and ASMI(H=6.182-113.853,χ^(2)=9.540,P<0.05).The multiple linear regression analysis showed that age was negatively correlated with the lowest T-score of BMD(β=-0.041,t=-2.834,P<0.05),and GNRI and ASMI were positively correlated with the lowest T-score of BMD(β=0.027-0.377,t=2.036-3.715,P<0.05).Conclusion The reduction in BMD in elderly women with T2DM is correlated with the increase in age,the reduction in GNRI,and muscle mass loss to a certain extent.