男性2型糖尿病患者骨密度的影响因素

Influencing factors of bone mineral density in male patients with diabetes mellitus type 2

目的探讨男性2型糖尿病(T2DM)患者骨密度(BMD)的影响因素。方法收集2018年7月至2020年8月于大同大学附属医院就诊的男性T2DM患者171例,按BMD值分为骨量正常组(67例)和骨量异常组(104例)。对两组年龄、病程、体重指数(BMI)、有无糖尿病性周围神经病变(DPN)史、空腹血糖(FBG)、糖化血红蛋白(HbA_(1c))、空腹C肽(FCP)、餐后2hC肽(2hCP)、同型半胱氨酸(Hcy)、尿酸(UA)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)进行比较,并采用二元logistics回归分析T2DM骨量异常的危险影响。结果骨量异常组年龄、病程、TC、LDL-C、HDL-C、Hcy水平和有DPN病者史占比显著高于骨量正常组,而BMI、2hCP、UA水平均低于骨量正常组,差异有统计学意义(P<0.05)。两组FCP、HbA_(1c)、FBG、TG水平比较,差异均无统计学意义(P>0.05)。二分类logistic回归分析显示,高LDL-C水平(OR=3.399,95%CI:1.293~8.936,P=0.013)和有DPN病史(OR=6.689,95%CI:1.733~25.816,P=0.006)是T2DM患者合并骨质异常的危险因素,高UA水平(OR=0.975,95%CI:0.964~0.986,P=0.000)是T2DM患者合并骨质异常的保护因素。结论维持稍高水平的血UA可能对BMD有保护作用,而高LDL-C水平和有DPN病史易导致T2DM患者出现骨量异常。

Objective To investigate the influencing factors of bone mineral density(BMD)in male patients with diabetes mellitus type 2(T2DM).Methods A total of 171 male T2DM patients admitted to Affiliated Hospital of Shanxi Datong University from July 2018 to August 2020 were divided into normal bone mass group(67 cases)and abnormal bone mass group(104 cases)according to BMD value.Age,course of disease,body mass index(BMI),with or without the history of diabetic peripheral neuropathy(DPN),fasting blood glucose(FBG),glycosylated hemoglobin(HbA_(1c)),fasting C peptide(FCP),postprandial 2hC peptide(2hCP),homocysteine(Hcy),uric acid(UA),high density lipoprotein-cholesterol(HDL-C),triglyceride(TG),total cholesterol(TC),and low density lipoprotein-cholesterol(LDL-C)were compared between the two groups,and the risk of abnormal bone mass in T2DM was analyzed by binary logistics regression.Results Age,course of disease,TC,LDL-C,HDL-C,Hcy levels,and the proportion of DPN history in abnormal bone mass group were significantly higher than those in normal bone mass group,while BMI,2hCP,and UA levels were lower than those in normal bone mass group,the differences were statistically significant(P<0.05).There were no significant differences in FCP,HbA_(1c),FBG,and TG levels between the two groups(P>0.05).Binary logistic regression analysis showed high LDL-C level(OR=3.399,95%CI:1.293-8.936,P=0.013)and a history of DPN(OR=6.689,95%CI:1.733-25.816,P=0.006)were risk factors for bone abnormalities in T2DM patients,and high UA level(OR=0.975,95%CI:0.964-0.986,P=0.000)was a protective factor for bone abnormalities in T2DM patients.Conclusion Maintaining a slightly higher serum UA level may have a protective effect on BMD,while high LDL-C level and a history of DPN may lead to abnormal bone mass in T2DM patients.