桡骨定量超声在中老年2型糖尿病患者骨质疏松诊断的应用价值

Application value of radial quantitative ultrasound in the diagnosis of osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus

目的探讨桡骨定量超声(QUS)在中老年2型糖尿病(T2DM)患者骨质疏松诊断的临床应用价值。方法308例中老年T2DM患者同时给予桡骨QUS和双能X射线吸收法(DXA)检查。记录不同年龄段患者骨质疏松发生情况,分析不同性别患者双侧桡骨QUS与腰椎L_(1)~L_(4)及双侧股骨颈DXA测量结果的相关性,采用ROC曲线分析桡骨QUS诊断骨质疏松的价值。结果随着年龄的增长,骨质疏松患者比例逐渐增加(P<0.01)。女性患者中,采用QUS测量双侧桡骨T值与DXA测量腰椎L_(1)~L_(4)、双侧股骨颈T值均呈正相关(P<0.05);而男性患者中,采用QUS测量右侧桡骨T值与DXA测量腰椎L_(1)~L_(4)、双侧股骨颈T值呈正相关(P<0.05)。ROC曲线结果显示,右侧桡骨QUS诊断女性和男性患者骨质疏松的AUC为0.602[95%CI(0.515~0.689),P<0.05]和0.656[95%CI(0.527~0.785),P<0.05]。结论桡骨QUS与DXA检测骨密度存在相关性;右侧桡骨QUS对诊断中老年T2DM患者骨质疏松有一定参考价值,但其诊断效能不高,不能完全替代DXA检查。

Objective To investigate the clinical application value of radial quantitative ultrasound(QUS)in the diagnosis of osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 308 middle-aged and elderly patients with T2DM accepted both examinations of radial QUS and dual energy X-ray absorptiometry(DXA).The incidence of osteoporosis in the patients with different ages was recorded.The correlation of bone mineral density between QUS of bilateral radius and DXA of lumbar vertebra L_(1)-L_(4)and bilateral femoral neck in different gender was analyzed.The ROC curve was used to analyze the value of radial QUS in the diagnosis of osteoporosis.Results The percentage of the patients with osteoporosis was gradually increased with increased age(P<0.01).The T values of bilateral radius measured by QUS were positively correlated with the T values of lumbar vertebra L_(1)-L_(4)and bilateral femoral neck measured by DXA in female patients(P<0.05).The T value of right radius measured by QUS was positively correlated with the T values of lumbar vertebra L_(1)-L_(4)and bilateral femoral neck measured by DXA in male patients(P<0.05).ROC curve analysis showed that the AUC of right radial QUS in the diagnosis of osteoporosis were 0.602[95%CI(0.515-0.689),P<0.05]and 0.656[95%CI(0.527-0.785),P<0.05]in female and male patients,respectively.Conclusion The radial QUS has a relation with DXA in the detection of bone mineral density.The right radial QUS may be helpful for the diagnosis of osteoporosis in middle-aged and elderly patients with T2DM,but it has a lower diagnostic efficiency and can not completely replace DXA.