男性2型糖尿病患者踝肱指数与骨密度的相关性  

Ankle brachial index and bone mineral density in male patients with type 2 diabetes mellitus

作　　者：王熙然[1] 裴育[1] 李全民[1] 朱艳秋[1] 陈艳梅[2] 张帆[1] 陈国昌[1] 詹志伟[1] 杜瑞琴[1] 胡晓强[1] 吴艳丹[1] 

机构地区：[1]解放军第二炮兵总医院内分泌科,北京市100088 [2]解放军北京军区总医院干部病房1科,北京市100700

出　　处：《中国组织工程研究与临床康复》2007年第49期9914-9917,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:有研究表明动脉硬化与骨质疏松存在共同的病理生理机制,实验拟验证男性2型糖尿病患者踝肱指数与骨密度的相关性。方法:选择2004-01/2007-01解放军第二炮兵总医院内分泌科住院的2型糖尿病男性患者257例,所有患者对实验知情同意。将所有患者以踝肱指数比值大小分两组,分别是踝肱指数≥0.9组42例和踝肱指数<0.9组215例。采用ES-1000SPM多普勒血流探测仪及美国NORLAND公司生产的双能X线骨密度仪进行踝肱指数、腰椎(L2～4)、左侧股骨颈、大转子、华氏三角区骨密度测定。结果:踝肱指数<0.9组股骨颈、大转子、华氏三角骨密度低于踝肱指数≥0.9组(P<0.05),空腹血糖、尿微量白蛋白、脑梗死合并症发生率高于踝肱指数≥0.9组(P<0.05)。以腰椎、股骨颈、大转子、华氏三角骨密度为因变量进行多元线性回归显示,骨密度与体质量指数呈正相关(偏回归系数为0.023,P=0.000),与年龄、踝肱指数、尿素氮、尿微量白蛋白呈负相关(偏回归系数分别为-0.270,-0.311,-0.037,-0.080,P均<0.05)。以年龄、糖尿病病程、体质量指数为协变量进行协方差分析,2组间股骨颈、大转子、华氏三角骨密度无统计学差异(P值分别为0.137,0.245,0.280)。结论:影响2组糖尿病患者骨密度的因素以年龄、体质量指数为主,踝肱指数是其影响因素之一,但不是主要因素。AIM： It is verified that arteriosclerosis and osteoporosis have the same physiopathologic mechanism. This study was aimed to analyze the correlation between ankle brachial index （ABI） and bone mineral density （BMD） in men with type 2 diabetes mellitus. METHODS： A total of 257 men with type 2 diabetes mellitus were enrolled at Department of Endocrinology, Second Artillery Forces General Hospital of Chinese PLA from January 2004 to January 2007. All patients signed the informed consent. The patients were divided into ABI≥0.9 group （n =42） and ABI〈 0.9 group （n =215） according to ABI. ABI was measured by ES-1000SPM Doppler blood stream detector and BMD at lumbar （L2-4）, left femur neck, greater trochanter and Fahrenheit triangular area was detected by dual energy X-ray absorptiometry （DEXA）. RESULTS： BMD at femur neck, greater trochanter and Fahrenheit triangular area was lower in the ABI 〈 0.9 group than the ABI ≥0.9 group （P 〈 0.05）. The levels of fasting plasma glucose, U-ALB and incidence of cerebral infarction complication were higher in the ABI 〈 0.9 group than the ABI ≥0.9 group （P 〈 0.05）. BMD levels at femur neck, greater trochanter and Fahrenheit triangular as dependent variable for multiple linear regression showed that BME was positively correlated with BMI （partial regression coefficient 0.023,P =0.000）, and negatively correlated with age, AMI, urea nitrogen and U-ALB （partial regression coefficient -0.270,-0.311,-0.037,-0.080,P 〈 0.05）. There was no significant difference between the BMD levels of these two groups by covariance analysis with age, diabetes duration and BMI as concomitant variable （P =0.137,0.245,0.280）. CONCLUSION： The BMD of difference sites is related to age and BMI in diabetes mellitus patients. ABI is one of its influential factors, but not main factor.

关 键 词：踝肱指数 2型糖尿病 骨密度 

分 类 号：R587.1[医药卫生—内分泌]