老年男性糖尿病患者骨质疏松与颈动脉粥样硬化的相关性研究

Study on the correlation between osteoporosis and carotid atherosclerosis in elderly men with diabetes mellitus

目的探讨张家口地区老年男性糖尿病患者骨质疏松与颈动脉粥样硬化的相关性,为骨质疏松及动脉硬化的防治工作提供更多科学依据。方法选择2017年9月至2019年9月在河北北方学院附属第一医院内分泌科收诊的老年男性2型糖尿病患者100例,统计其年龄、体重指数、糖尿病病程、高血压、吸烟、饮酒、胰岛素应用史及相关生化指标。测定患者股骨颈骨密度和颈动脉内-中膜厚度(IMT),根据相关标准将100例患者分为颈动脉粥样硬化组(66例)和非动脉粥样硬化组(34例)。比较两组临床特征的差异,分析骨密度值与IMT的相关性。结果两组年龄、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白水平及股骨颈骨密度比较,差异有统计学意义(P<0.05)。颈动脉粥样硬化组骨质疏松发生率高于非动脉粥样硬化组,差异有统计学意义(P<0.05)。骨密度值与颈动脉IMT值呈负相关(r=-0.605,P<0.05)。结论年龄、高血糖、高血脂等因素均能影响老年男性糖尿病患者的颈动脉粥样硬化,其骨质疏松与颈动脉粥样硬化存在显著相关性,因而在预防颈动脉粥样硬化的同时,需密切关注骨质疏松的发生,从而降低骨折风险。

Objective To investigate the relationship between osteoporosis and carotid atherosclerosis in elderly male diabete mellitus patients in Zhangjiakou region,and to provide more scientific basis for the prevention and treatment of osteoporosis and arteriosclerosis.Methods A total of 100 elderly male patients with type 2 diabetes mellitus who were treated in the Department of Neurology,the First Affiliated Hospital of Hebei North University from September 2017 to September 2019 were selected.The age,body mass index,course of diabetes,hypertension,smoking,alcohol consumption,insulin application history,and related information were collected.The femoral neck bone mineral density and carotid intima-media thickness(IMT)were measured,and 100 patients were divided into carotid atherosclerosis group(66 cases)and non-atherosclerosis group(34 cases)according to relevant standards.The differences in clinical characteristics of the two groups were compared,and the correlation between bone mineral density and IMT was analyzed.Results There were significant differences in age,total cholesterol,triglyceride,low-density lipoprotein cholesterol,fasting blood glucose,glycosylated hemoglobin levels,and bone mineral density of femoral neck between the two groups,and the differences were statistically significant(P<0.05).The incidence of osteoporosis in the carotid atherosclerosis group was higher than that in the non-atherosclerosis group,and the difference was statistically significant(P<0.05).Bone mineral density values were negatively correlated with carotid IMT values(r=-0.605,P<0.05).Conclusion Aging,hyperglycemia,hyperlipidemia and other factors can affect carotid atherosclerosis in elderly male diabetes mellitus patients,and there is a significant correlation between osteoporosis and carotid atherosclerosis.Therefore,while preventing carotid atherosclerosis,it is necessary to pay close attention to the occurrence of osteoporosis,so as to reduce the risk of fracture.