老年男性2型糖尿病患者骨质疏松相关因素分析  

Analysis of osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus

作　　者：徐萍[1] 徐岷[2] 秦岩[2] 施良[3] 袁国跃[1] 杨玲[1] 

机构地区：[1]江苏大学附属医院内分泌科,江苏镇江212001 [2]江苏大学附属医院消化科,江苏镇江212001 [3]江苏大学附属医院核医学科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2016年第2期164-167,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:探讨老年男性2型糖尿病患者发生骨质疏松的危险因素。方法:选取154例老年男性2型糖尿病住院患者,采用双能X线骨密度仪测定患者骨密度,根据测定结果将其分为骨密度正常组、骨量减少组和骨质疏松组,测定体质量指数(BMI)、糖化血红蛋白(Hb A1c)、空腹及餐后2 h血糖、空腹及餐后2 h C肽、血Ca2+、总胆固醇、血浆三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸、超敏C反应蛋白(hs-CRP)等指标。结果:1与骨密度正常组相比,骨量减少组和骨质疏松组患者的年龄、糖尿病病程均明显增高(P<0.05),而BMI明显减低(P<0.01)。2与骨密度正常组相比,骨量减少组和骨质疏松组患者的Hb A1c、hs-CRP均明显增高(P<0.05),空腹及餐后2 h C肽明显降低(P<0.05),而空腹及餐后2 h血糖、血Ca2+、总胆固醇、血浆三酰甘油、HDL-C、LDL-C、血尿酸等指标3组间差异无统计学意义(P>0.05)。结论:老年男性2型糖尿病患者的骨密度与患者的年龄、病程和BMI有关,其中BMI是保护性因素,胰岛功能差、长期血糖控制不佳是导致骨质疏松的危险因素;hs-CRP在老年男性2型糖尿病患者骨质疏松的发生中有一定的作用。Objective： To study the osteoporosis-related risk factors in elderly male patients with type 2 diabetes mellitus. Methods： A total of 154 elderly male patients with type 2 diabetes were divided into three groups： normal group, osteopenia group and osteoporosis group. Bone mineral density （BMD） were measured by dual-energy X-ray absorptiometly（DXA）. BMI, HbAlc, FBG, PBG, fasting C peptide, post- prandial C peptide, serum calcium （CaR＋ ） , TG, TC, LDL-C, HDL-C, serum uric acid and hs-CRP were measured. Results： The age and duration of diabetes in osteopenia group and osteoporosis group were sig- nificantly higher than those of normal group （P 〈 0.05 ） , while BMI in osteopenia group and osteoporosis group was significantly lower than that of normal group （P 〈 0.01 ）. HbA1 c and hs-CRP significantly in- creased in osteopenia group and osteoporosis group compared with normal group, while fasting C peptide, postprandial C peptide significantly decreased. There was no significant difference in FBG, PBG, serum calcium （Ca2＋）, TC, TG, HDL-C, LDL-C, and serum uric acid among the three groups（P 〉0.05）. Conclusion： The BMD of elderly male type 2 diabetes patients may be correlated with the age, duration of diabetes and BMI. Bigger BMI may be a protective factor, while poor insulin function and poor control of blood glucose may be risk factors. In addition, inflammatmy factor hs-CRP may play roles in the pathogene- sis of osteoporosis in elderly male type 2 diabetes patients.

关 键 词：骨质疏松 2型糖尿病 骨密度 超敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]