社区非低体重绝经后2型糖尿病女性股骨颈强度综合指数的相关研究

A study on the composite indices of femoral neck strength in non-low-weight postmenopausal women with type 2 diabetes mellitus in community

目的探讨非低体重绝经后2型糖尿病女性髋部骨折风险、股骨颈强度综合指数变化及其影响因素。方法选取非低体重绝经后女性626例,根据2010年美国糖尿病协会糖尿病诊断标准分为2型糖尿病组、糖尿病前期组、非糖尿病组。每位参与者均完成问卷调查、体格检查、实验室检查及双能X线吸收仪(DXA)检查。结果2型糖尿病组髋部骨折发生率显著高于非糖尿病组(3.4%对0.7%,P<0.05),而糖尿病前期组与非糖尿病组无明显差异(1.1%对0.7%,P>0.05)。腰椎1-4、股骨颈和全髋骨密度2型糖尿病组与非糖尿病组、糖尿病前期组与非糖尿病组相比差异均无统计学意义(P>0.05)。2型糖尿病组股骨颈强度综合指数显著低于非糖尿病组(P<0.05),但糖尿病前期组与非糖尿病组无明显差异(P>0.05)。回归分析显示,年龄、体重指数是股骨颈骨密度、股骨颈强度综合指数的主要影响因素(P<0.05)。结论股骨颈强度综合指数可作为评估2型糖尿病患者髋部骨折风险的方法之一。

Objective To explore the risk of hip fracture,changes of composite indices of femoral neck strength and its influential factors in non-low-weight postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 626 non-low-weight postmenopausal women were selected and divided into type 2 diabetes group,pre-diabetic group,and non-diabetic group according to the diagnostic criteria of the American Diabetes Association in 2010.Each participant completed the questionnaire,physical examination,laboratory examination,and Dual-energy X-ray absorptiometry(DXA)examination.Results Hip fracture rate in T2DM group was significantly higher than that in non-diabetic group(3.4%vs 0.7%,P<0.05),while no significant difference was observed between pre-diabetic group and non-diabetic group(1.1%vs 0.7%,P>0.05).Bone mineral density(BMD)of lumbar spine 1-4,femoral neck,and total hip was comparable between T2DM group and non-diabetic group or pre-diabetic group and non-diabetic group,respectively(P>0.05).The composite indices of femoral neck strength in T2DM group was significantly lower than that in non-diabetic group(P<0.05),but there was no significant difference between pre-diabetic group and non-diabetic group(P>0.05).Regression analysis showed that age and body mass index were the main influential factors of the femoral neck bone mineral density and the composite indices of femoral neck strength(P<0.05).Conclusion The composite indices of femoral neck strength could be used as one of the markers to evaluate the risk of hip fracture in type 2 diabetic patients.