2型糖尿病患者骨量丢失的保护因素分析

目的探讨2型糖尿病患者代谢指标对骨代谢的影响及对抗骨质疏松的保护因素。方法纳入261例2型糖尿病住院患者为研究对象,分别对其年龄、性别、体质量指数(BMI)、糖尿病病程、是否抽烟、饮酒、是否患有高血压及降糖药物治疗方案进行调查分析,并检测其糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、血清肌酐(Scr)、尿微量白蛋白肌酐比值(ACR),β-胶原特殊系列(β-CTX)、总I型胶原氨基端延长肽(P1NP)、骨钙素(OC)等指标,根据骨密度分为骨量正常组(NC组)124例,骨量减少/骨质疏松组(OP组)137例。比较两组之间各指标的差异性。结果2型糖尿病合并骨量减少/骨质疏松患者中男性为37.3%,女性为65%,且该组患者具有低BMI,低UA,低TG的特点,差异均有统计学意义(P<0.05)。多元逐步回归分析结果提示性别、年龄、BMI和TG是2型糖尿病患者骨代谢的影响因素。结论高BMI和高TG是2型糖尿病患者对抗骨质疏松的独立保护因素。

Objective To explore the metabolic indicators of type 2 diabetes patients that have a protective effect on bone metabolism.Methods Two hundred and sixty-one inpatients with Type 2 diabetes mellitus(T2DM)were included in the study.The clinical data(age,Sex,body mass index(BMI),course of disease,whether drink or smoke,hypertension and antidiabetic drugs)and laboratory parameters(HbAIc,Tc,Tg,LDL-C,HDL-C,UA,Scr,ACR,β-CTX,P1NP and OC)were collected.Patients were divided to osteoporosis group(NC group,124 cases)and non-OP group(137 cases)according to the BMD values.The differences of indicators between the two groups were compared.Results Patients in OP group included 37.3%of men and 65%of women.OP group have lower BMI,lower uric acid,and lower triglyceride levels.The differences were statistically significant(P<0.05).Multiple stepwise regression analysis revealed that age,Sex,BMI and Tg were the main factors that influencing the change of BMDs in patients with T2DM.Conclusion BMI and TG are independent protective factors against OP in patients with T2DM.