FRAX联合血清学指标评估老年T2DM患者骨质疏松风险的研究

Evaluation of Osteoporosis Risk in Elderly Patients with T2DM by FRAX Combined with Serological Markers

目的探讨老年2型糖尿病(T2DM)患者的血清学指标、骨密度及FRAX骨折风险评分的变化与骨质疏松之间的关系。方法选择2020年6月-2021年1月在我院就诊的老年T2DM患者68例作为观察组,另选同期健康人48名作为对照组,比较两组血清学指标、骨密度水平,采用骨折危险评估工具计算髋部骨折风险及主要骨质疏松率,分析T2DM合并骨质疏松的临床特征。结果观察组血糖、碱性磷酸酶、血钙、血磷水平均高于对照组,骨密度低于对照组,差异有统计学意义(P<0.05);相关性分析显示,T2DM患者骨密度与血清钙、磷水平呈正相关(r=0.379、0.047,P<0.05),与碱性磷酸酶呈负相关(r=-0.523,P<0.05);ROC生存曲线显示,髋部骨折风险、主要骨质疏松率对T2DM患者骨折风险的评估具有早期识别作用。结论FRAX骨折风险评分联合血清学指标可较准确的筛查出高骨质疏松风险的老年糖尿病患者,该法有助于临床及时对患者进行干预,改善其预后。

Objective To investigate the relationship between the changes of serum markers,bone mineral density and FRAX fracture risk score in elderly patients with type 2 diabetes mellitus(T2DM)and osteoporosis.Methods A total of 68 elderly patients with T2DM who were treated in our hospital from June 2020 to January 2021 were selected as the observation group,and 48 healthy people in the same period were selected as the control group.The serological indexes and bone mineral density levels of the two groups were compared.The fracture risk assessment tool was used to calculate the risk of hip fracture and the main osteoporosis rate,and the clinical characteristics of T2DM combined with osteoporosis were analyzed.Results The levels of blood glucose,alkaline phosphatase,serum calcium and serum phosphorus in the observation group were higher than those in the control group,and the bone mineral density was lower than that in the control group(P<0.05).Correlation analysis showed that bone mineral density was positively correlated with serum calcium and phosphorus levels(r=0.379,0.047,P<0.05),and negatively correlated with alkaline phosphatase(r=-0.523,P<0.05).The ROC survival curve showed that hip fracture risk and major osteoporosis rate had early identification effect on fracture risk assessment in T2DM patients.Conclusion FRAX fracture risk score combined with serological indicators can accurately screen out elderly diabetic patients with high risk of osteoporosis.This method is helpful for timely clinical intervention and improvement of prognosis.