老年糖尿病患者骨密度与血尿酸水平的相关研究  

Study of the relationship between bone mineral density and serum uric acid in senile diabetic patients

作　　者：赵娜[1] 李素梅[1] 方星星[1] 李春燕[1] 荆春艳[1] 叶山东[1] 任安[1] 

机构地区：[1]安徽医科大学附属省立医院内分泌科,合肥230001

出　　处：《中国骨质疏松杂志》2014年第7期784-788,共5页Chinese Journal of Osteoporosis

基　　金：安徽省卫生厅医学科研课题(13zc017)

摘　　要：目的横断面观察老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨密度及血尿酸水平,探讨两者之间的相关性。方法选择明确诊断为T2DM且年龄在60岁以上的患者254例,搜集患者资料,分别行骨密度测定,依据T值水平将患者分为骨量正常组(n=89例),骨量减少组(n=86例)及骨质疏松组(osteoporosis,OP,n=79例);依据血尿酸水平将患者分为高尿酸血症组(血尿酸≥420μmol/L)和血尿酸正常组(血尿酸<420μmol/L)。结果 (1)老年T2DM男性患者血尿酸及各部位骨密度值均高于女性,OP患病率低于女性,差异具有统计学意义(P<0.05)。(2)男性患者血尿酸与腰椎1至4联合值(the lumbar vertebrae,L1-4)及Wards三角部位的骨密度呈正相关(r=0.366,P=0.009;r=0.367,P=0.008),女性患者血尿酸与各部位骨密度无明显相关性(P>0.05)。(3)高尿酸血症组患者的血尿酸与股骨颈及大转子部位的骨密度呈负相关(r=-0.374,P=0.025;r=-0.535,P=0.001),血尿酸正常组血尿酸与股骨颈部位的骨密度呈正相关(r=0.212,P=0.010)。结论老年T2DM患者骨密度受性别及血尿酸水平的影响,正常偏高水平的血尿酸有利于稳定骨量。Objective To determine bone mineral density （BMD） and the level of serum uric acid in senile patients with type 2 diabetes mellitns （T2DM） through cross-sectional observation, and to investigate the relationship between them. Methods A total of 254 senile T2DM patients, who were definitely diagnosed and over 60 years old, were selected into this study. The clinical data were collected. BMD of all the patients was detected. The patients were divided into 3 groups according to T values： normal bone mass group （n = 89） , osteopenia group （ n = 86） , and osteoporosis group （ OP, n = 79）. In addition, they were also groupd on the basis of serum uric acid levels： high uric acid group （blood uric acid ≥420 μmol/L） and normal group （blood uric acid 〈 420 μmol/L）. Results The serum uric acid and BMD of each part in senile male T2DM patients were higher than those in female patients, while the incidence of OP was lower than that in female patients, and the difference was significant （P 〈 0.05）. In male patients, the serum uric acid level was positively correlated with BMD of L1-4 and the Wards triangle （ r = 0. 366, P = 0. 009 ; r = 0. 367, P = 0. 008）. But no significant correlation was in female patients （P 〉 0.05）. In high uric acid group, the serum uric acid level was negatively correlated with BMD of the femoral neck and the greater trochanter （ r = - 0. 374, P = 0. 025 ; r = - 0. 535, P = 0. 001 ）. However, in normal uric acid group, the serum uric acid level was positively correlated with BMD of the femoral neck （ r = 0. 212, P = 0. 010）. Conclusion BMD in senile T2DM patients was affected by gender and serum uric acid levels. The high - normal levels of serum uric acid are useful to stable BMD.

关 键 词：糖尿病 骨质疏松 尿酸 

分 类 号：R587.1[医药卫生—内分泌] R696.6[医药卫生—内科学]