血清Hb、NLR、SUA/CR与糖尿病骨质疏松患者临床风险因素及利拉鲁肽治疗效果的相关性  

Correlation of serum hemoglobin,neutrophil to lymphocyte ratio,and serum uric acid-to-creatinine ratio with clinical risk factors in patients with diabetic osteoporosis and the therapeutic effect of liraglutide

作　　者：李进[1] 禹远远[1] 刘艳晓[1] 崔晓磊[1] 王俊宏[1] 吴小丽 LI Jin;YU Yuan-yuan;LIU Yan-xiao;CUI Xiao-lei;WANG Jun-hong;WU Xiao-li(Department of Endocrinology and Metabolism,the First People's Hospital of Pingdingshan,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院内分泌代谢科,河南平顶山467000

出　　处：《海南医学》2024年第13期1835-1839,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关项目(编号:LHG232102310304)。

摘　　要：目的分析血清血红蛋白(Hb)、中性粒细胞与淋巴细胞比值(NLR)、血尿酸/肌酐比值(SUA/CR)与糖尿病骨质疏松(DOP)患者临床风险因素的关系,并探讨三者与利拉鲁肽治疗后骨密度的相关性。方法回顾性分析2020年1月至2023年1月平顶山市第一人民医院内分泌科收治的185例糖尿病患者的临床资料,根据是否合并骨质疏松将其分为骨质疏松组58例和无骨质疏松组127例。比较两组患者的血清Hb、NLR、SUA/CR水平;经二元Logistic回归模型分析DOP的临床风险因素;采用Pearson相关性分析法分析骨质疏松患者血清Hb、NLR、SUA/CR与临床风险因素的相关性;骨质疏松组患者均采用利拉鲁肽治疗,比较其治疗前后的骨密度;采用Pearson相关性分析法分析血清Hb、NLR、SUA/CR与治疗后骨密度的相关性。结果与无骨质疏松组比较,骨质疏松组患者的年龄更大,体质量指数(BMI)、握力降低,糖尿病病程延长,差异均有统计学意义(P<0.05)。骨质疏松组患者的血清Hb水平为(112.67±15.33)g/dL,明显低于无骨质疏松组的(129.78±19.27)g/dL,而NLR、SUA/CR分别为2.68±0.57、(84.53±9.71)mg/g,明显高于无骨质疏松组的2.17±0.48、(57.63±7.17)mg/g,差异均有统计学意义(P<0.05)。二元Logistic回归模型分析结果显示,年龄(OR=8.919,95%CI:1.904~41.788)、糖尿病病程(OR=6.830,95%CI:1.147~40.689)是DOP的危险性因素,而BMI(OR=0.331,95%CI:0.148~0.738)、握力(OR=0.292,95%CI:0.121~0.705)是其保护性因素(P<0.05)。Pearson相关性分析结果显示,年龄、糖尿病病程与血清Hb呈负相关(P<0.05),BMI、握力与血清NLR、SUA/CR呈负相关(P<0.05);年龄、糖尿病病程与血清NLR、SUA/CR呈正相关(P<0.05);BMI、握力与血清Hb呈正相关(P<0.05)。骨质疏松患者经利拉鲁肽治疗后的骨密度为(0.79±0.16)g/cm^(2),明显高于治疗前的(0.65±0.12)g/cm^(2),差异有统计学意义(t=9.521,P<0.05)。Pearson相关性分析结果显示,血清Hb与治疗后骨密度呈Objective To analyze the relationship of serum hemoglobin(Hb),neutrophil to lymphocyte ratio(NLR),and serum uric acid to creatinine ratio(SUA/CR)with clinical risk factors of diabetic osteoporosis(DOP),and to explore the correlation between Hb,NLR,SUA/CR and bone mineral density after treatment with liraglutide.Methods The clinical data of 185 diabetic patients admitted to the Department of Endocrinology,the First People's Hospital of Pingdingshan from January 2020 to January 2023 were retrospectively analyzed.They were divided into osteoporosis group(58 cases)and non-osteoporosis group(127 cases)according to whether they had osteoporosis.The levels of serum Hb,NLR,SUA/CR were compared between the two groups.The clinical risk factors of DOP were analyzed by binary Logistic regression model.The correlation between serum Hb,NLR,SUA/CR and clinical risk factors was analyzed by Pearson correlation analysis in the osteoporosis group.The patients in the osteoporosis group were treated with liraglutide,and the patients'bone mineral density before and after treatment was compared.The correlation between serum Hb,NLR,SUA/CR and bone mineral density after treatment was analyzed by Pearson correlation analysis.Results Compared with those in the non-osteoporosis group,the patients in the osteoporosis group were older,the body mass index(BMI)and grip strength were lower,and the course of diabetes was longer,with statistically significant differences(P<0.05).The serum Hb level in the osteoporosis group was(112.67±15.33)g/dL,which was significantly lower than(129.78±19.27)g/dL in the non-osteoporosis group;and the NLR,SUA/CR in the non-osteoporosis group were 2.68±0.57,(84.53±9.71)mg/g,significantly higher than 2.17±0.48,(57.63±7.17)mg/g in the osteoporosis group(P<0.05).Binary logistic regression model analysis showed that age(OR=8.919,95%CI:1.904-41.788)and diabetes duration(OR=6.830,95%CI:1.147-40.689)were risk factors for DOP,while body mass index(BMI)(OR=0.331,95%CI:0.148-0.738)and grip strength(OR=0.292,95%CI:0.121-

关 键 词：糖尿病骨质疏松 血红蛋白 中性粒细胞与淋巴细胞比值 尿酸/肌酐比值 利拉鲁肽 相关性 

分 类 号：R587.2[医药卫生—内分泌]