2型糖尿病患者合并骨质疏松的危险因素分析

Risk Factors of Osteoporosis in Patients with Type 2 Diabetes Mellitus

目的:调查2型糖尿病患者合并骨质疏松的发病情况,并进行危险因素分析,为预防及控制糖尿病性骨质疏松的发生和发展提供临床依据.方法:选取2021年3月—2023年4月我院收治的77例2型糖尿病患者作为研究对象,检测所有患者的骨密度与判定骨质疏松发生情况,调查与记录患者的一般资料、生化检测数据并进行危险因素分析.结果:在77例患者中,判断为骨质疏松15例(骨质疏松组),占比19.5%.骨质疏松组的左侧髋关节、股骨颈、正位第1~4腰椎的骨密度均低于非骨质疏松组,组间差异有统计学意义(P<0.05).2组的性别、体质指数、受教育年限对比,组间差异无统计学意义(P>0.05);2组的年龄、糖尿病病程对比,组间差异有统计学意义(P<0.05).骨质疏松组的血清总胆固醇、糖化血红蛋白、碱性磷酸酶、空腹血糖水平均高于非骨质疏松组,组间差异有统计学意义(P<0.05);2组的甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇对比,组间差异无统计学意义(P>0.05).Spearman分析显示年龄、糖尿病病程、总胆固醇、糖化血红蛋白、碱性磷酸酶、空腹血糖与骨质疏松的发生存在相关性(P<0.05).多因素Logistic回归分析显示年龄、糖尿病病程、总胆固醇、糖化血红蛋白、碱性磷酸酶、空腹血糖都为导致骨质疏松发生的危险因素(P<0.05).结论:2型糖尿病患者多合并有骨质疏松,年龄、糖尿病病程、总胆固醇、糖化血红蛋白、碱性磷酸酶、空腹血糖都为导致骨质疏松发生的危险因素,在临床上要进行针对性预防管理.

Objective:To investigate the incidence of osteoporosis in patients with type 2 diabetes and analyze the risk factors,so as to provide clinical basis for preventing and controlling the occurrence and development of diabetic osteoporosis.Methods:77 patients with type 2 diabetes admitted to our hospital from March 2021 to April 2023 were selected as research objects,bone mineral density of all patients was detected and the incidence of osteoporosis was determined,general information and biochemical detection data of patients were investigated and recorded,and risk factors were analyzed.Results:Among the 77 patients,15 cases were judged to be osteoporosis(osteoporosis group),accounting for 19.5%.Bone mineral density(BMD)of the left hip joint,femoral neck,and the 1st to 4th lumbar vertebra in the osteoporosis group was lower than that of the non-osteoporosis group,and the differences were statistically significant(P<0.05).There were no significant differences in gender,body mass index and years of education between the two groups(P>0.05).There were significant differences in age and diabetes course between the two groups(P<0.05).The levels of serum total cholesterol,glycated hemoglobin,alkaline phosphatase and fasting blood glucose in osteoporosis group were higher than those in non-osteoporosis group,with statistical significance(P<0.05).There was no significant difference in triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol between the two groups(P>0.05).Spearman analysis showed that age,diabetes course,total cholesterol,glycated hemoglobin,alkaline phosphatase,fasting blood glucose were correlated with the occurrence of osteoporosis(P<0.05).Multivariate Logistic regression analysis showed that age,diabetes course,total cholesterol,glycosylated hemoglobin,alkaline phosphatase and fasting blood glucose were all risk factors for osteoporosis(P<0.05).Conclusion:Most patients with type 2 diabetes are complicated with osteoporosis.Age,diabetes course,total cholesterol,glycated hemoglobin,alkaline phosphatase and fasting blood glucose are all risk factors leading to osteoporosis,and targeted prevention and management should be carried out in clinic.