2型糖尿病患者骨密度减低的特征分析

Characteristics of bone mineral density loss in type 2 diabetic patients

目的:研究2型糖尿病患者骨密度减低特征,寻求进行康复干预的可能性。方法:对89例2型糖尿病患者(糖尿病组)进行了股骨近端(Neck、Troch和Ward's三角)及正位腰椎(L2～4)的骨密度测定,并与相同年龄、性别和居住地区的正常人(对照组)比较。结果:糖尿病组的骨密度值犤L2(0.70±0.21)g/cm2,L3(0.74±0.18)g/cm2和L4(0.76±0.19)g/cm2〗明显低于对照组(t=2.116～2.304,P均<0.05),但两组间股骨股骨颈、大转子和Ward's三角骨密度值无明显区别(P均>0.05)。糖尿病患者按病程分组后,病程长组(≥7.5年,52例)股骨和腰椎大部分骨密度值均明显低于病程短组(<7.5年,37例)(t=1.947～2.166,P均<0.05)。按有无视网膜病变分组后,有视网膜病变组(49例)股骨近端和正位腰椎的大部分骨密度值均明显低于无视网膜病变组(40例)(t=2.195～2.392,P均<0.05)。按有无微量白蛋白尿分组后,有微量白蛋白尿(尿微量白蛋白30～300mg/24h)组(35例)的股骨近端和正位腰椎的全部骨密度值均明显低于无微量白蛋白尿组(54例)(t=2.165～2.308,P均<0.05)。结论:2型糖尿病患者常出现骨密度减低表现,后者常与病程、有无视网膜病变和微量白蛋白尿密切相关。

AIM:To study the characteristics of bone mineral density(BMD) loss in type 2 diabetic patients,and to explore the possibility of rehabilitation intervention. METHODS:The BMD of proximal femur(neck,Troch and Ward's triangle)and orthopic lumbar vertebrae(L2- 4) of 89 type 2 diabetic patients(diabetic group) were measured,and were compared to normal subjects(control group)with the same age, sex and living area. RESULTS: The values of BMD in the diabetic group[L2(0.70± 0.21) g/cm2, L3(0.74± 0.18) g/cm2 and L4( 0.76± 0.19) g/cm2 ]were obviously lower than those in the control group(t=2.116- 2.304, P< 0.05), but there was no significant difference in the BMD values of neck, Troch, Ward's triangle between both groups (P >0.05).Most BMD values of femur and lumbar vertebrae in patients with long diabetic disease course(≥ 7.5 years, 37 cases) were obviously lower than those with short course(< 7.5 years, 49 cases)(t=1.947- 2.166, P< 0.05).Most BMD values in patients with retinopathy(49 cases) were obviously lower than those without retinopathy (40 cases)(t=2.195- 2.392,P< 0.05). All BMD values in patients with albuminuria(30- 300 mg/24 h, 35 cases) were obviously lower than those without albuminuria(54 cases)(t=2.165- 2.308, P< 0.05). CONCLUSION:The BMD loss is common in type 2 diabetic patients, and is closely related to the disease course, retinopathy and albuminuria