上海市延吉社区老年人群糖尿病合并骨质疏松症临床特征及危险因素分析  

Analysis of clinical features and risk factors for patients with diabetic osteoporosis in elder residents of Yanji community in Shanghai

作　　者：王琳[1] 王丽娜[1] 徐桢莹[1] 顾伟[1] 岳小强[1] 刘龙[1] 杨学[1] 李霞[1] 潘静娟[1] 方凡夫[1] 朱德增[1] 

机构地区：[1]第二军医大学长海医院中医系,上海200433

出　　处：《中国慢性病预防与控制》2016年第3期187-191,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市卫生计划委员会科研项目(20134483);军队中医药科研专项课题(10ZYZ128)

摘　　要：目的对社区老年居民中糖尿病合并骨质疏松（DOP）人群临床特征及危险因素进行调查,为进一步开展干预提供基线数据和理论依据。方法于2012年10月至2013年10月,采用二阶段随机抽样方法对上海市杨浦区延吉社区2 038例60~90岁常住居民进行病史调查、空腹血糖检测、X线检查及骨密度测试,调查对象分为单纯2型糖尿病（T2DM）、单纯骨质疏松症（OP）、糖尿病合并骨质疏松症（DOP）患者和无糖尿病及骨质疏松者（NORM）组,进行问卷调查、体格检查和实验室检测。应用SPSS 15.0软件进行统计分析,危险因素分析采用logistic回归分析。结果 2 038例调查人群中,资料完整者2 024例,其中T2DM患者228例,占11.26%;OP患者594例,占29.35%;DOP患者111例,占5.49%;NORM组1 091例,占53.90%。DOP组的平均年龄、体重、收缩压、甘油三酯及糖化血红蛋白均高于OP组;平均年龄、高密度脂蛋白胆固醇高于T2DM组,体质指数及糖化血红蛋白低于T2DM组;平均年龄、收缩压及糖化血红蛋白高于NORM组,体质指数低于NORM组,差异均有统计学意义（P〈0.05,P〈0.01）。logistic回归分析显示,该社区DOP人群的相关因素是糖尿病并发症（OR=20.425,95%CI：12.822~32.536）、性别（OR=3.629,95%CI：2.097~6.279）、高血压史（OR=2.811,95%CI：1.753~4.507）、血钙（OR=2.248,95%CI：1.071~4.720）、骨折史（OR=2.076,95%CI：1.207~3.573）和年龄（OR=1.056,95%CI：1.027~1.087）。结论针对DOP的危险因素,应当对相关人群进行早期诊断和早期干预,以减少骨质疏松骨折的发生。Objective To study the clinical features and risk factors of diabetic osteoporosis（DOP） in elderly residents of Yanji community and to provide the basis for prevention. Methods During October of 2012 to October of 2013, 2 038 elderly residents（60-90 years old） of Yanji community in Shanghai were selected as the subjects by two stage random sampling method. The investigation for medical history, fasting plasma glucose, X-ray and bone density examinations were performed. The subjects were divided into the diabetes mellitus（T2DM） group, the osteoporosis（OP） group, the DOP group and the no T2 DM and OP（NORM）group. The investigation was conducted by questionnaire, physical examination and laboratory tests. The logistic regression method was used to analyze the risk factors with SPSS 15.0 software. Results In 2 038 subjects, there were 2 024 cases with whole data,including 228 T2 DM cases（11.26%）, 594 OP cases（29.35%）, 111 DOP cases（5.49%）, and 1 091 NORM cases（53.90%）.Average age, weight, systolic pressure, triglyceride（TG） and Hb A1 Clevels in DOP group were significantly higher than those in OP group, average age and HDL-C levels in DOP group were significantly higher than those in T2 DM group, average BMI and Hb A1 C levels in DOP group were significantly lower than those in T2 DM group, average age, systolic pressure and Hb A1 Clevels in DOP group were significantly higher than those in NORM group, and average BMI in DOP group was significantly lower than that in NORM group（P〈0.05 or P〈0.01）. The logistic regression analysis showed that the related risk factors in DOP group were T2 DM complications（OR =20.425, 95% CI：12.822-32.536）, gender（OR =3.629, 95% CI： 2.097-6.279）, hypertension history（OR =2.811, 95%CI： 1.753-4.507）, blood calcium（OR=2.248, 95%CI： 1.071-4.720）, fracture history（OR=2.076, 95%CI： 1.207-3.573） and age（OR=1.056, 95%CI： 1.027-1.087）. Conclusion According to risk factors, the early diagnosis and intervention for r

关 键 词：糖尿病 2型 骨质疏松 危险因素 

分 类 号：R587.1[医药卫生—内分泌]