老年男性2型糖尿病合并骨质疏松相关因素分析  

Relative factors analysis of type 2 diabetes mellitus complicated with osteoporosis in elderly men

作　　者：张清[1] 陈雨[1] 

机构地区：[1]首都医科大学附属复兴医院干部保健科,北京市100038

出　　处：《中国基层医药》2015年第21期3251-3255,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨老年男性2型糖尿病（T2DM）患者并发骨质疏松的相关因素，为老年糖尿病合并骨质疏松患者的防治提供指导。方法采用双能 X 线骨密度仪测定67例老年男性糖尿病患者骨密度（BMD），将其分为骨质疏松组（OP 组）32例、非骨质疏松组（NOP 组）35例，比较两组患者的年龄、体质量指数（BMI）、糖尿病病程、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、胰岛素敏感指数（ISI）、尿白蛋白定量（ALb）、24 h 尿蛋白定量和碱性磷酸酶（ALP）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）等指标之间的差异，并进行相关性分析。结果与 NOP 组比较，OP 组患者年龄大，病程长，BMI 低，骨密度低，ALP 高， FINS 水平低，ISI 低，HbA1c 高，24 h 尿蛋白定量和 ALb 高，LDL-C 高，差异均有统计学意义（均 P ＜0．05）；老年男性 T2DM患者的骨密度与年龄、病程、HbA1c、24 h 尿蛋白定量、ALb、ALP、LDL-C 呈负相关，与 BMI、FINS、ISI 呈正相关。结论老年男性糖尿病患者发生骨质疏松与多因素有关，高龄、糖尿病病程长、体质量低、血糖控制不佳、胰岛功能差、胰岛素抵抗、血 ALP 偏高、LDL-C 高、糖尿病肾病等均是老年男性 T2DM合并骨质疏松的相关因素。Objective To investigate and analyze the relative factors in elderly men with type 2 diabetes mellitus（T2DM）complicated with osteoporosis（OP）,thus to provide guidance for prevention of OP complicated with T2DM in elderly men.Methods Dual X -ray absorptiometry determination of bone mineral density （BMD）of 67 cases of elderly men with diabetes,men were divided into OP group （n =32）,NOP group （n =35）.Then,we compared differences in body mass index（BMI）,diabetes duration,fasting plasma glucose （FPG）,glycosylated hemo-globin（HbA1c）,patients＇age,fasting insulin（FINS）,insulin sensitivity index（ISI）,quantitative of urinary albumin （ALb）,quantitative of urinary protein in 24 hours and alkaliphosphatase level（ALP）,low density lipoprotein choles-terin（LDL -C）,triglyceride（TG）,and made correlation analysis.Results Compared with those in NOP group,pa-tients in OP group had older age,longer disease course,smaller baric index,lower BMD,higher ALP,lower FINS,low-er ISI,higher HbA1c,higher quantitative of urinary protein in 24 hours and urinary albumin,higher LDL -C,which were significantly different （P 〈0.05）;BMD of elderly men with T2DM was negatively correlated to patients＇age, disease course,HbA1c,quantitative of urinary protein in 24 hours,ALb,ALP and LDL -C,but positively correlated to BMI,FINS and ISI.Conclusion Many factors,such as elderly,low body weight,long duration of the disease,high level of blood sugar,insulin dysfunction,low insulin sensitivity,high level of blood suger,insulin dysfunction,low insulin sensitivity,high serum alkalinephosphatase,high LDL -C and diabetic nephropathy,contribute to osteoporosis in elderly men with T2DM.

关 键 词：糖尿病 2 型 骨密度 骨质疏松 男(雄)性 老年人 因素分析 DIABETES mellitus type 2 

分 类 号：R587.1[医药卫生—内分泌] R580[医药卫生—内科学]