2型糖尿病绝经后女性患者血尿酸水平与骨密度和骨折的相关性研究

Correlation between serum uric acid level and bone mineral density and fracture in postmenopausal women with type 2 diabetes

目的评估血清尿酸(uric acid,UA)与骨密度(bone mineral density,BMD)和绝经后2型糖尿病(type 2 diabetes mellitus,T2DM)女性患者临床骨折患病率的关系。方法收集980例接受BMD测量和临床骨折评估的绝经后T2DM患者,测量血清尿酸(uric acid,UA)浓度。结果与骨密度正常和骨质减少的患者相比,患有骨质疏松症的绝经T2DM患者血清UA浓度较低。绝经后妇女的血清UA浓度与腰椎、股骨颈和全髋的BMD值显著相关。此外,临床骨折患者的血清UA低于无骨折患者。多因素Logistic回归分析显示,在调整年龄、体质量指数、糖尿病病程、空腹血糖、糖化血红蛋白A1c(HbA1c)、碱性磷酸酶后,血清UA浓度与临床骨折存在显著正相关。当模型进一步调整每个部位的BMD值时,结果没有统计学意义。结论较低的血清UA浓度可能与较低的BMD值和较高的临床骨折患病率相关。

Objective To evaluate the relationship of serum uric acid(UA)with bone mineral density(BMD)and clinical fracture rate in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 980 postmenopausal T2DM patients who underwent BMD measurements and clinical fracture assessment were enrolled to measure serum UA concentrations.Results Postmenopausal T2DM patients with osteoporosis had lower serum UA concentrations than patients with normal bone density or osteopenia.Serum UA concentrations in postmenopausal women were significantly associated with BMD values of the lumbar spine,femoral neck,and total hip.In addition,patients with clinical fractures had lower serum UA than patients without fracture.Multivariate logistic regression analysis showed that serum UA concentration was significantly positively correlated with clinical fracture after adjusting for age,BMI,duration of diabetes,fasting blood glucose(FBG),glycosylated hemoglobin A1 c(HbA1 c),and alkaline phosphatase(ALP).When the models were further adjusted for the BMD value of each site,the result were no longer statistically significant.Conclusion Lower serum UA concentrations may be associated with lower BMD values and higher clinical fracture prevalence.