不同糖代谢状态下绝经后骨质疏松症患者骨折情况的研究  

Research on fractures inpatients with postmenopausal osteoporosis under different glucose metabolism status

作　　者：苏兰[1] 袁丽[1] 杨小玲[1] SU Lan;YUAN Li;YANG Xiao-ling(Department of Endocrinology&Metabolism,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院内分泌代谢科,四川成都610041

出　　处：《实用医院临床杂志》2024年第6期70-73,共4页Practical Journal of Clinical Medicine

基　　金：国家自然科学基金-青年科学基金项目(编号:81700087);四川省科学技术厅重点研发项目(编号:2019YFS0305)。

摘　　要：目的探讨不同糖代谢状态下绝经后骨质疏松症患者的骨折情况,为该人群骨折的早期防治提供依据。方法回顾性分析2019年1月1日至2023年8月9日于我院内分泌代谢科住院诊治的绝经后骨质疏松症患者240例,根据不同糖代谢状态分为糖耐量正常、糖尿病前期、新诊断糖尿病组,采用多因素Logistic回归分析糖代谢状态对绝经后骨质疏松症患者骨折情况的影响。结果240例患者中,糖代谢异常94例(39.2%),骨折患者56例(23.3%)。与糖耐量正常组比较,糖尿病前期和新诊断糖尿病的骨折风险分别是其1.10(1.00~1.20)倍和1.29(1.14~1.47)倍(P<0.05)。糖代谢异常人群骨折风险的增加独立于体质量指数、25-羟基维生素D和骨密度(P<0.05)。结论绝经后骨质疏松症患者中,糖代谢异常人群较糖代谢正常人群骨折风险显著升高,且该差异在糖尿病前期阶段就已存在。糖代谢异常是绝经后骨质疏松症患者骨折的独立危险因素。Objective To investigate the fracture status of postmenopausal women with osteoporosis under different glucose metabolism states,and to provide a basis for early prevention and treatment of fracture.Methods A total of 240 postmenopausal women with osteoporosis in a tertiary hospital between January 1,2019 and August 9,2023 were retrospectively analyzed.According to whether they were accompanied by fracture,the patients were divided into a fracture group and a non-fracture group.According to different glucose metabolism status,they were further divided into a normal glucose tolerance group,a pre-diabetes group and a diabetes group.Multivariate logistic regression analysis was used to analyze the effect of glucose metabolism on fracture in these patients.Results In the 240 patients,there were 94(39.2%)with abnormal glucose metabolism and 56(23.3%)with fracture.The fracture risks of the pre-diabetes group was 1.10(1.00~1.20)times that of the normal glucose tolerance group.The fracture risks of the newly diagnosed diabetes group was 1.29(1.14~1.47)times that of the normal glucose tolerance group.All differences were statistically significant(P<0.05).The increased risk of fracture in the patients with abnormal glucose metabolism was independent of BMI,25-hydroxyvitamin D and bone mineral density(P<0.05).Conclusions Among postmenopausal women with osteoporosis,the risk of fracture is significantly higher in patients with abnormal glucose metabolism than that in patients with normal glucose metabolism.This difference has existed in the pre-diabetic phase.Abnormal glucose metabolism is an independent risk factor for fracture in those patients.

关 键 词：2型糖尿病 糖代谢异常 骨质疏松 骨折 绝经后女性 

分 类 号：R681[医药卫生—骨科学]