糖尿病性骨质疏松症致病因素相关性分析  

Correlation analysis among the influential factors of diabetic osteoporosis

作　　者：陈玉华 戴芳芳[1] CHEN Yuhua;DAI Fangfang(Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中国骨质疏松杂志》2021年第5期641-645,共5页Chinese Journal of Osteoporosis

基　　金：国家重点研发计划项目(2018YFC2002503);江苏省中医院科技项目(Y18014)。

摘　　要：目的探讨糖尿病性骨质疏松症(diabetic osteoporosis,DOP)的相关因素,并为进一步治疗提供相关依据。方法随机选取2019年6~12月2型糖尿病(type 2 diabetes mellitus,T2DM)患者134例,男75例,女59例。分为骨量正常组(A组)、骨质减少组(B组)、骨质疏松组(C组)。分析这三组患者的性别、年龄、病程、腰围、体质量指数(BMI)、血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、空腹血糖(FPG)、糖化血清蛋白(GSP)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三脂(TG)、1型胶原羧基末端肽(β-CTx)、总1型前胶原氨基末端肽(P1NP)、25羟维生素D3[25(OH)D3]、甲状旁腺激素(PTH)、骨钙素(OC)、空腹C肽(FCP)和降钙素(CT)的差异。结果三组患者间年龄、腰围、BMI、血P、TG、TC、LDL-C、GSP、HbA1c、P1NP、25(OH)D3和OC的差异均有统计学意义(P<0.05);相关分析结果显示,腰围、25(OH)D3、P1NP和OC与BMD呈负相关(P<0.05),血磷、HbA1c、β-CTx与BMD呈正相关(P<0.05);二分类Logistic回归分析结果表明,在T2DM患者中P1NP和β-CTx对BMD水平有影响,其中P1NP为保护因素(OR=0.946,P<0.05),β-CTx为危险因素(OR=1.012,P<0.001)。结论P1NP和β-CTx是DOP的影响因素;P1NP为DOP的保护因素,β-CTx为危险因素。Objective This paper investigates the risk factors of diabetic osteoporosis(DOP)and provides the guidance for the further treatment.Methods From June 2019 to December 2019,134 patients with type 2 diabetes(75 males and 59 females)were collected.They were divided into 3 subgroups:normal BMD subgroup(Group A),osteopenia subgroup(Group B),and osteoporosis subgroup(Group C).The clinical data(sex,age,diabetes duration,waistline,and BMI)and laboratory parameters(Ca,P,ALP,FPG,GSP,HbA1c,TC,HDL-C,LDL-C,TG,β-CTx,P1NP,25(OH)D3,PTH,OC,FCP,and CT)were compared among the 3 groups.Results The age,waistline,BMI,P,TG,TC,LDL-C,GSP,HbA1c,P1NP,25(OH)D3,and OC were significantly different among the 3 subgroups(P<0.05).Waistline,25(OH)D3,P1NP,and OC were negatively correlated with BMD(P<0.05).P,HbA1c,andβ-CTx were positively correlated with BMD(P<0.05).In the binary logistic regression analysis,P1NP andβ-CTx were influential factors,P1NP was a protective factor(OR=0.946,P<0.05),andβ-CTx was a risk factor(OR=1.012,P<0.001).Conclusion P1NP andβ-CTx are influential factors of DOP.P1NP is a protective factor of DOP.β-CTx is a risk factor of DOP.

关 键 词：糖尿病性骨质疏松症 总1型前胶原氨基末端肽 1型胶原羧基末端肽 25羟维生素D3 

分 类 号：R587.1[医药卫生—内分泌]