武汉大学人民医院住院2型糖尿病患者骨密度及其影响因素  

Bone mineral density and influencing factors in hospitalized patients with type 2 diabetes mellitus in Renmin Hospital of Wuhan University

作　　者：汪梦洁 毛拓华[1] 李竞[1] WANG Meng-jie;MA;L(Department of Endocrinology ,Renmin Hospital of Wuhan University, Wuhan Hubei ,430060, Chin)

机构地区：[1]武汉大学人民医院内分泌科,湖北武汉430060

出　　处：《职业与健康》2018年第8期1075-1078,1082,共5页Occupation and Health

基　　金：青年教师基金资助项目(2042017kf0157)

摘　　要：目的探索住院2型糖尿病(T2DM)患者骨密度(BMD)情况及合并骨质疏松症(OP)的相关影响因素。方法选取2014年3月—2017年3月在武汉大学人民医院住院的460例2型糖尿病患者,使用双能X线照射法(DEXA)测定患者的BMD,根据T值不同分为骨量正常组、骨量减少组、OP组;比较3组之间各临床指标的差异并进行相关性分析。结果 (1)住院T2DM患者中骨量异常的检出率达40%以上,其中女性患者的检出率大于男性,差异有统计学意义(P<0.05);(2)3组患者在年龄、体质指数(BMI)、BMD、血红蛋白(Hb)、碱性磷酸酶(ALP)、促甲状腺激素(TSH)、血肌酐(Cr)、肾小球滤过率(eGFR)、尿酸(UA)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹C肽(FCP)及2hC肽(2hCP)中比较,差异有统计学意义(P<0.05);(3)Pearson相关性分析显示,T2DM患者的BMD与BMI、Hb、AST(天冬氨酸转氨酶)、ALT(丙氨酸转氨酶)、尿素氮(Urea)、Cr、eGFR、UA、TG、FCP、2hCP成正相关,与年龄、ALP、HDL-C呈负相关;(4)多元逐步回归分析显示,骨密度与BMI、Hb、ALP、Cr、eGFR、UA、HDL-C独立相关。结论女性、低体重、贫血、高ALP、低UA、高HDL-C及肾功能异常更易患糖尿病性骨质疏松症(DOP)。[Objective]To investigate the change of bone mineral density（BMD） in hospitalized patients with type 2 diabetes mellitus（T2 DM） and influential factors of combined osteoporosis（OP）. [Methods] 460 hospitalized patients with T2 DM in Renmin Hospital of Wuhan University from March 2014 to March 2017 were recruited in the study. The dual energy X-ray absorptiometry（DEXA） was used to measure BMD,and the patients were divided into 3 groups according to T score,including normal BMD group,reduced BMD group and OP group. The clinical data among three groups were compared and the correlation analysis was performed. [Results]（1）The detection rate of abnormal BMD among hospitalized with T2DM was above 40%,while the examination rate in females was higher than that in males,and the difference was statistically significant（P〈0.05）.（2）There were statistically significant differences in age,body mass index（BMI）,BMD,hemoglobin（Hb）,alkaline phosphatase（ALP）,thyroid stimulating hormone（TSH）,creatinine（Cr）,estimated glomerular filtration rate（e GFR）,uric acid（UA）,triglycerides（TG）,high density lipoprotein cholesterol（HDL-C） fasting C peptide（FCP） and 2hC peptide（2hCP） among three groups（P〈0.05）.（3）Pearson analysis showed that BMD was positively correlated with BMI,Hb,aspartate aminotransferase（AST） and ALT（alanine aminotransferase）,urea,Cr,e GFR,UA,TG,FCP and 2hCP,and negatively correlated with age,ALP and HDL-C.（4） Multivariate stepwise regression analysis showed that BMD was independently associated with BMI,Hb,ALP,Cr,e GFR,UA,HDL-C.[Conclusion] The people who are female and have low body weight,anemia,high ALP,low UA,high HDL-C and abnormal renal function are more susceptible to Diabetic osteoporosis.

关 键 词：2型糖尿病 骨密度 骨质疏松 

分 类 号：R181.3[医药卫生—流行病学]