老年糖尿病合并骨质疏松症患者股骨颈骨密度与HbA1c及骨代谢指标的相关性分析  

Correlation analysis of femoral neck bone mineral density with HbA1c and bone metabolism in elderly diabetes mellitus patients with osteoporosis

作　　者：廖勇[1] 童利伟[1] 邓春颖[1] 黄世春 LIAO Yong;TONG Li-wei;DENG Chun-ying(Department of Endocrinology and Metabolic Diseases,Zigong Fourth People's Hospital,Zigong Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院内分泌与代谢性疾病科,四川自贡643000

出　　处：《临床和实验医学杂志》2022年第22期2415-2418,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生和计划生育科研项目(编号:20PJ080)。

摘　　要：目的研究老年2型糖尿病(T2DM)合并骨质疏松症(OP)患者股骨颈骨密度与糖化血红蛋白(HbA1c)及骨代谢指标的相关性。方法采用回顾性分析方法,以2020年1月至2022年1月入自贡市第四人民医院的180例老年T2DM合并OP患者为观察对象,参考双能X线测定股骨颈骨密度结果分为A组(骨量正常,60例)、B组(骨量减少,60例)、C组(骨质疏松,60例)。记录3组患者的一般资料(年龄、性别、体重指数及糖尿病病程),比较3组患者的股骨颈骨密度、碱性磷酸酶(ALP)、甲状旁腺素(PTH)、血钙、血磷、糖化血红蛋白(HbA1c)、空腹血糖(FBG)与β-异构C-端肽(β-CTX)、Ⅰ型胶原氨基端肽原(PINP)水平,分析股骨颈骨密度与年龄、病程、体重指数、FBG、HbA1c、β-CTX、PINP的相关性。结果3组患者性别构成比比较,差异无统计学意义(P>0.05);相较A、B组,C组平均年龄更高,体重指数更低,病程更长,差异均有统计学意义(P<0.05)。3组患者ALP、PTH、血钙、血磷水平比较,差异均无统计学意义(P>0.05);相较A、B组,C组股骨颈骨密度更低,HbA1c、FBG水平更高,差异均有统计学意义(P<0.05)。相较A、B组,C组β-CTX、PINP水平更高,差异均有统计学意义(P<0.05)。股骨颈骨密度与年龄、病程、FBG、HbA1c、β-CTX、PINP呈负相关,与体重指数呈正相关(P<0.05)。结论T2DM合并OP患者的FBG、HbA1c、β-CTX、PINP均处于较高水平,而股骨颈骨密度较低,HbA1c、β-CTX、PINP是影响股骨颈骨密度的关键性因素,监测HbA1c、β-CTX、PINP水平有利于提升早期诊治T2DM合并OP的精准性。Objective To study the correlation of femoral neck bone mineral density with glycated hemoglobin(HbA1c)and bone metabolism indexes in elderly patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP).Methods A retrospective analysis method was used to select 180 elderly patients with T2DM and OP who were admitted to the Fourth People's Hospital of Zigong City from January 2020 to January 2022 as the observation objects,and were divided into group A with reference to the results of dual energy X-ray measurement of bone mineral density of the femoral neck.(normal bone mass,60 cases),group B(osteopenia,60 cases),group C(osteoporosis,60 cases).The general data(age,gender,body mass index and duration of diabetes)of the three groups of patients were recorded,and the femoral neck bone mineral density,alkaline phosphatase(ALP),parathyroid hormone(PTH),and serum calcium,phosphorus,hemoglobin A1c(HbA1c),fasting blood glucose(FBG)andβ-isomeric C-terminal peptide(β-CTX),type I collagen amino terminal peptide(PINP)level were compared among the three groups,and the correlation between femoral neck BMD and age,body weight,disease course,FBG,HbA1c,β-CTX and PINP was analyzed.Results There was no significant difference in the ratio of male to female among three groups(P>0.05);compared with groups A and B,average age of group C were higher,body mass index were lower,and disease duration were longer,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of ALP,PTH,calcium,phosphorus among 3 groups(P>0.05);compared with groups A and B,femoral neck BMD of group C were lower,the levels of HbA1c and FBG were higher,and the differences were statistically significant(P<0.05).Compared with groups A and B,the levels ofβ-CTX and PINP in group C were higher,and the differences were statistically significant(P<0.05).Femoral neck BMD was negatively correlated with age,disease course,FBG,HbA1c,β-CTX,PINP,and positively correlated with body mass index(P<0.05).Conclu

关 键 词：老年 2型糖尿病 骨质疏松 股骨颈骨密度 β-异构C-端肽 Ⅰ型胶原氨基端肽原 

分 类 号：R580[医药卫生—内分泌] R587.2[医药卫生—内科学]