2型糖尿病患者血清25-羟维生素D水平对发生骨质疏松的风险预测模型构建  

Serum 25-hydroxyvitamin D level in patients with type 2 diabetes mellitus and construction of risk prediction model for osteoporosis occurrence

作　　者：侯新华[1] 高英[2] 马依拉·买买提[1] HOU Xinhua;GAO Ying;Mayila·maimaiti(Department of Clinical Nutrition;Department of Comprehensive Cardiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院临床营养科,乌鲁木齐830054 [2]新疆医科大学第一附属医院综合心脏内科,乌鲁木齐830054

出　　处：《重庆医学》2025年第2期324-328,334,共6页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82160610)。

摘　　要：目的 构建2型糖尿病患者血清25-羟维生素D[25-(OH)D]水平对发生骨质疏松的风险预测模型。方法 选取2021年1月至2023年7月于该院进行治疗的542例2型糖尿病患者,根据骨质疏松发生情况分别骨质疏松组(n=57)和无骨质疏松组(n=485)。检测患者血清25-(OH)D水平,通过单因素、多因素logistic回归分析2型糖尿病发生骨质疏松的危险因素,建立风险预测模型,并绘制受试者工作特征(ROC)曲线分析风险预测模型对2型糖尿病发生骨质疏松的预测价值。结果 542例2型糖尿病患者中25-(OH)D充足、不足、缺乏、严重缺乏者分别为18例(3.32%)、156例(28.78%)、324例(59.78%)、44例(8.12%),男性25-(OH)D充足、不足比例高于女性,缺乏、严重缺乏比例低于女性(P<0.05)。多因素logistic分析结果显示,年龄≥60岁、2型糖尿病病程延长、女性、25-(OH)D缺乏为2型糖尿病发生骨质疏松的危险因素(OR=1.813、1.706、2.162、1.654,P<0.05);体重指数(BMI)升高为2型糖尿病发生骨质疏松的保护因素(OR=0.542,P<0.05)。将上述因素纳入风险预测模型:logit(P)=-13.799+年龄×0.595-BMI×0.612+2型糖尿病病程×0.534+性别×0.771+血清25-(OH)D水平×0.503。将2型糖尿病发生骨质疏松患者纳入阳性,2型糖尿病未发生骨质疏松患者纳入阴性,按照风险预测模型绘制预测2型糖尿病发生骨质疏松的ROC曲线,结果显示,当logit(P)>5.67时,曲线下面积(AUC)为0.917,诊断灵敏度为78.95%、特异度为87.63%。结论 2型糖尿病患者发生骨质疏松与年龄≥60岁、2型糖尿病病程延长、女性、25-(OH)D缺乏、BMI降低等多种因素有关。Objective To analyze the serum 25-hydroxyvitamin D[25-(OH)D]level in the patients with type 2 diabetes mellitus(T2DM),and to construct a risk prediction model for osteoporosis occurrence.Methods A total of 542 patients with T2DM treated in this hospital from January 2021 to July 2023 were selected and devided into the osteoporosis group(n=57)and non-osteoporosis group(n=485)according to whether or not osteoporosis occurred.The serum 25-(OH)D level in the patients with T2DM was detected.The risk factors of T2DM complicating osteoporosis were analyzed by the univariate and multivariate Logistic regression.The risk prediction model was established,and the predictive value of the risk prediction model for T2DM complicating osteoporosis was analyzed by drawing the receiver operating characteristic(ROC)curve.Results Among 542 patients with T2DM,the cases and proportions of 25-(OH)D sufficient,insufficient,deficient and severely deficient were as follows:18 cases(3.32%),156 cases(28.78%),324 cases(59.78%)and 44 cases(8.12%),respectively.The proportions of males in the 25-(OH)D sufficient group and 25-(OH)D insufficient group were higher than those of females,the proportion of male in the deficiency group and severe deficiency group was lower than that of female(P<0.05).The multivariate Logistic analysis results showed that age≥60 years old,prolonged course of T2DM,female and lack of serum 25-(OH)D level were the risk factors for T2DM complicating osteoporosis(OR=1.813,1.706,2.162,1.654,P<0.05).The body mass index(BMI)increase was a protective factor for T2DM complicating osteoporosis(OR=0.542,P<0.05).The above factors were included in the risk prediction model:logit(P)=-13.799+age×0.595-BMI×0.612+T2DM duration×0.534+sex×0.771+serum 25-(OH)D level×0.503.The patients with T2DM complicating osteoporosis were included in the positive category and those with T2DM without osteoporosis were included in the negative category.The ROC curve for predicting the occurrence of T2DM complicating osteoporosis was drawn according

关 键 词：2型糖尿病 骨质疏松 25-羟维生素D 危险因素 模型 受试者工作特征曲线 

分 类 号：R580[医药卫生—内分泌] R587.2[医药卫生—内科学]