男性2型糖尿病患者腹型肥胖降低股骨的骨密度  

Decreased bone mineral density is associated with visceral obesity in male type 2 diabetes patients

作　　者：孙军卫[1] 唐伟[1] 施广德[1] 黄文龙[1] 郭晓珍[1] 郁卫刚[1] 金晖[2] 

机构地区：[1]东南大学附属江阴市人民医院内分泌科,江苏江阴214400 [2]东南大学附属中大医院内分泌科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2013年第4期498-501,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:分析肥胖对男性2型糖尿病患者不同部位骨密度的影响。方法:收集199例男性2型糖尿病患者,运用双能X线骨密度仪测量受试者腰椎(L1～4)和股骨部(股骨颈、Ward’s三角、全髋)的骨密度。再根据体质指数、腰围进行分组对比,比较不同的肥胖类型对各部位骨密度的影响,并分析腰围、臀围、腰臀比、腰高比与骨密度的关系。结果:根据体质指数分组,肥胖患者各部位骨密度均显著增高。腰围≥90 cm的腹型肥胖患者腰椎各部位骨密度显著增加,而在股骨(股骨颈和Ward’s三角)这种显著性差异消失;根据股骨颈的T值分组,发现骨质疏松组年龄更大、体重更轻、BMI更小、腰围更小、臀围更小。多因素相关分析显示各部位的骨密度均与身高、体重、BMI、腰围、臀围呈显著正相关,而仅股骨部位骨密度与年龄负相关。校正身高和体重后,股骨颈骨密度与腰高比和臀围负相关,Ward’s三角部位的骨密度与腰围、臀围、腰高比负相关。结论:2型糖尿病的男性患者股骨的骨密度与腹型肥胖负相关,提示腹型肥胖可能对2型糖尿病患者股骨骨密度有不良影响。Objective：To determine the effect of obesity on bone mineral density of lumbar spine and hip in male patients with type 2 diabetes. Methods：The study was carried out in 199 male with type 2 diabetes. Bone mineral density （BMD） at the sites of lumbar spine and hip （lumbar spine L1-L4,femoral neck,Ward＇s triangle and total hip） were obtained by dual X-ray absorptiometry. The influence of obesity on BMD was evaluated. Results：According to body mass index,BMDs at lumber spines,total hip,femoral neck and ward＇s triangle were significantly higher in obesity subjects compared with non-obese subjects. BMDs at lumber spines and total hip were significantly higher in visceral obesity objects define as waist circumference not less than 90 cm. The significant difference was disappeared in femoral neck and Ward＇s triangle. Compared with subjects with normal BMD and osteopenia,those with osteoporosis had lower weight, BMI,waist circumference and hip circumference and were older. BMDs were positively correlated with height,weight,BMI,waist circumference and hip circumference. Only BMDs at hip were negatively correlated with age. After correction of height and weight,BMDs at femoral neck negatively correlated with waist-to-height ratio （r = -0.179,P = 0.019） and hip circumference （r = -0.179,P = 0.019）. BMDs at ward＇s triangle negatively correlated with waist （r = -0.177,P = 0.019）, hip circumference （r = -0.227,P = 0.002） and waist-to-height ratio （r = -0.229,P = 0.002）. Conclusion：Visceral obesity in male type 2 diabetes patients is related to lower BMDs at hip and the risk of osteoporosis.

关 键 词：骨密度 腹型肥胖 2型糖尿病 男性 

分 类 号：R587.1[医药卫生—内分泌]