老年男性2型糖尿病患者骨质疏松与慢性血管并发症的关系  

Relationship between osteoporosis and chronic vascular complications in elderly male patients with type 2diabetes

作　　者：程飞[1] 赵敏[1] 康慨[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院内分泌科,100038

出　　处：《中华老年医学杂志》2013年第6期609-611,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨老年男性2型糖尿病患者骨质疏松与慢性血管并发症的相关性。方法对428例老年男性2型糖尿病患者使用双能x线骨密度仪测量腰椎L2-4、股骨颈、Wards三角的骨密度值，同时评价患者慢性血管并发症，并对两者相关性进行分析。结果骨质疏松组糖尿病病程、空腹血糖、餐后2h血糖水平高于非骨质疏松组（P〈0．05）；骨质疏松组糖尿病‘肾病、糖尿病视网膜病变、糖尿病神经病变和高血压发生率（分别为59．8％、41．8％、33．6％和35．7％）高于非骨质疏松组（分别为12．0％、22．3％、24．5％和26．1％）（X^2=100、848、17．066、4．208、4．448，均P〈0．05）。Logistic回归分析显示，糖尿病病程（OR-1．055，95％CI：1．015～1．096，P-0．007）、空腹血糖（OR-1．168，95％CI：1．073～1．273，P-0．001）和糖尿病肾病（0R-7．401，95％CI：4．303-12．727，P-0．001）与糖尿病骨质疏松的发生相关。结论老年男性2型糖尿病患者骨质疏松与其微血管并发症密切相关；糖尿病肾脏是促进骨质疏松发生和进展的因素之一；定期对尿白蛋白等微血管并发症指标进行监测和早期综合干预，有助于老年2型糖尿病患者骨质疏松的早期防治。Objective To explore the relationship between osteoporosis and chronic vascular complications in elderly male patients with type 2 diabetes and to evaluate its related risk factors. Methods A retrospective study was conducted in 428 elderly type 2 diabetic patients. The bone mineral density （BMD） of lumbar spines （L2 -L4）, femoral neck, Wardrs triangle were measured by dual X-ray absorptiometry, and chronic vascular complications in patients were tested. The correlation between BMD and chronic vascular complications was analyzed. Results Diabetic course was longer in osteoporosis group than in non-osteoporosis group （P〈0.05）. Levels of fasting blood glucose （FBG） and postprandial blood glucose （PBG） were significantly higher in osteoporosis group than in non-osteoporosis group （P〈0.05） . The incidences of diabetic nephropathy, diabetic retinopathy, diabetic neuropathy and hypertension were higher in osteoporosis group than in non-osteoporosis group （59.8% vs. 12.0%,41.8% vs. 22. 3%,33. 6% vs. 24.5%,and35.7%0 vs. 26.%, respectively, all P〈 0.05）. I.ogistic analysis showed that diabetic course, FBG and diabetic nephropathy were correlated with diabetic osteoporosis （OR= 1. 055, 1. 168, 7. 401, 95% CI： 1. 015-1. 096, 1. 073- 1.273, 4.303-12.727, P= 0.007, 0.001, 0.001）. Conclusions Osteoporosis has a close relationship with diabetic microvascular complications in elderly diabetic patients. Diabetic nephropathy plays an important role in the development of diabetic osteoporosis. It is helpful for osteoporosis prevention to early monitor and intervene on microvascular complications index such as urinary albumin in elderly patients with type 2 diabetes.

关 键 词：糖尿病 2型 骨质疏松 糖尿病血管病变 

分 类 号：R587[医药卫生—内分泌]