绝经后2型糖尿病妇女骨质疏松与颈动脉粥样斑块关系的初探  

Correlation between atherosclerosis and osteoporosis in postmenopausal women with type 2 diabetes

作　　者：黄祺[1] 朱圣炜[1] 程海燕[1] 卜瑞芳[1] 

机构地区：[1]南京医科大学附属无锡人民医院内分泌科,无锡214023

出　　处：《中国骨质疏松杂志》2016年第1期72-75,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨绝经后2型糖尿病妇女骨质疏松与颈动脉粥样硬化的相关性,为患者的预防治疗提供依据。方法回顾性分析在我科住院的100例绝经后2型糖尿病妇女,均行颈动脉彩超,观察颈动脉内膜中层的厚度及斑块的情况,依据超声的诊断结果分成有斑块组和无斑块组;采用双能X线骨密度仪检测所有患者腰椎1~4及左髋部的骨密度。结果 （1）有斑块组与无斑块组相比,年龄、糖尿病病程、体重指数、血压、血脂、血糖等一般资料在两组间的差异无统计学意义（P均〉0.05）,而前组第1~4腰椎骨密度均值明显低于后组,差异有统计学意义（P均〈0.05）;（2）绝经后2型糖尿病妇女颈动脉内膜中层厚度的均值与腰椎1~4骨密度均值呈负相关（r=-0.219,P〈0.05）,与空腹血糖、糖化血红蛋白呈正相关（r=0.295~0.300,P均〈0.05）。结论在绝经后2型糖尿病妇女中腰椎1~4骨密度的减少是加速颈动脉粥样斑块出现的危险因素,反之粥样斑块形成也促进腰椎骨质的流失,因此治疗和预防时应采用系统性的措施。Objective To study the relationship between atherosclerosis and osteoporosis in postmenopausal women with type 2 diabetes, and to provide evidence for the prevention and treatment for the patients. Methods A total of 100 postmenopausal women with type 2 diabetes in our department were included in this retrospective study. Intima-media thickness of carotid artery was examined using color Doppler ultrasound. According to the ultrasonic results all the patients were divided into plaque group and non- plaque group. Bone mineral density of the lumbar vertebrae （L1-4） and the left hip was detected using dual energy X-ray absorptiometry. Results （1） Compared with those in non-plaque group, age, duration of diabetes, body mass index, blood pressure, lipid, glucose, and other general information had no significant difference （P 〉 0. 05）. The average bone mineral density of L1-4 were lower in plaque group than that in non-plaque group （P 〈 0. 05）. （2） The average thickness of carotid intima-media was negatively correlated with bone mineral density of L1-4, and it is positively correlated with fasting blood glucose and glycosylated hemoglobin content （P 〈 0. 05 ）. Conclusion The decrease of average of bone mineral density of L1-4 is a risk factor for carotid atherosclerosis in postmenopausal women with type 2 diabetes. Meanwhile, carotid arteriosclerosis may speed up the bone loss of the lumbar vertebra. So it is necessary to take systematic measure to prevent them.

关 键 词：骨质疏松 颈动脉粥样硬化 2型糖尿病 绝经后 

分 类 号：R592[医药卫生—老年医学]