不同糖代谢水平>50岁男性人群骨密度与血糖、内脏脂肪面积及肌肉质量的关系  

Relationship of 2-h plasma glucose,abdominal visceral fat and lean mass with bone mineral Density in men over 50 years under different glucose metabolism status

作　　者：刘炎[1] 贾晓娇[1] 刘晓丽[1] 石蕊 刘鑫[1] 王菲 陆强[1] 王锐[1] LIU Yan;JIA Xiaojiao;LIU Xiaoli(First Hospital of Qinhuangdao,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院,066000

出　　处：《河北医药》2023年第6期857-860,864,共5页Hebei Medical Journal

摘　　要：目的 了解不同糖代谢状态>50岁男性人群血糖及内脏脂肪面积与骨密度的关系。方法 经口服葡萄糖耐量试验(OGTT)筛选出正常糖耐量组(NGT组)90例、糖调节异常(IGR)组66例及新发2型糖尿病组48例,测量测量血糖浓度、人体参数、体成分和骨密度等,采用方差分析(ANOVA)、Pearson相关和多元线性回归模型评价骨密度(BMD)、血糖、内脏脂肪面积(AVF)等变量之间的关系。结果 总受试人群中52.94%存在骨量减少或骨质疏松(OP),其中新发T2DM组68.75%,高于IGR组(54.54%)和NGT组(43.33%);新发T2DM组股骨颈和腰椎骨密度均低于NGT组(P<0.05),AVF有增大趋势;脂肪质量(fat mass)和肌肉质量(lean mass)均在IGR组最高,新发T2DM组反而下降。单因素相关分析显示,股骨颈骨密度与AVF及Lean mass呈正相关(P<0.05),与空腹血糖(FPG)、糖负荷后2 h血糖(2hPG)呈负相关(P<0.05);而腰椎骨密度除与FPG、2hPG呈负相关外(P<0.05),与AVF、Lean mass等体成分指标无相关性(P>0.05)。多元线性回归和Logistic回归分析结果剔除了FPG对骨密度的影响,肯定了2hPG对骨密度的消极影响,以及Lean mass和AVF对骨密度的积极影响。结论 不同糖代谢状态>50岁男性人群中,与FPG相比,2hPG对腰椎和股骨颈骨密度的消极影响更显著,Lean mass以及一定程度的AVF增加对骨密度的影响是积极的;2hPG和AVF异常的人群更应关注BMD的变化。Objective To investigate the relationship between blood glucose,abdominal visceral fat(AVF)and bone mineral density(BMD)in men over 50 years under different glucose metabolism status.Methods The oral glucose tolerance test(OGTT)were performed to screen the three groups which comprised 90(normal glucose tolerance,NGT group),66(impaired glucose regulation,IGR group),and 48(primary diagnosed type 2 DM,T2DM group)patients.Glucose concentrations,human body parameters,body composition,and BMD were measured.Analysis of variance(ANOVA),Pearson correlation,and multiple linear regression models were used to evaluate the relationship between blood glucose,AVF and BMD.Results The percentage of subjects with osteoporosis(OP)or low BMD was 52.94%;the percentage of subjects in T2DM group were higher than those in the IGR groupand NGT group(68.75%vs 54.54%vs 43.33%,P<0.05,respectively).Both BMD at femoral neck(FN)and lumbar spine(LS)in T2DM group were lower than those in NGT group(P<0.05),and AVF tends to an increase.Fat Mass and Lean Mass were highest in IGR group,but decreased in new T2DM group.The results of single factor correlation analysis revealed that FN BMD was positive correlation with both AVF and Lean mass,negative correlation withFPG,2-h plasma glucose(2-h PG).Apart from negative correlation with FPG and 2-h PG,LS BMD was no correlation with AVF and lean mass.Multiple linear regression analysis showed there was no effect of FPG on BMD,but the negative effect of 2-h PG on BMD and the positive effect of Lean Mass and AVF on BMD were confirmed.Conclusion Compared with FPG,2-h PG had more significant negative effects on BMD of LS and FN,while lean mass and a certain increase of AVF had positive effects on BMD in men over 50 years with different glucose metabolism status.The abnormal 2-h PG and AVF should be paid more attention to the changes of BMD of these individuals.

关 键 词：不同糖代谢 2H血糖 内脏脂肪面积 骨密度 

分 类 号：R681.4[医药卫生—骨科学]