2型糖尿病患者发生骨质疏松危险因素及与血脂代谢相关性  

Risk factors of osteoporosis and its correlation with lipid metabolism in patients with type 2 diabetes mellitus

作　　者：陈未艾 黄大伟 蔡松 CHEN Wei-Ai;HUANG Da-Wei;CAI Song(Departement of Cardiology and Endocrinology,Longfu Hospital of Beijing,Beijing 100010,China)

机构地区：[1]北京市隆福医院心血管内分泌科,北京100010 [2]北京市隆福医院检验科,北京100010

出　　处：《吉林医学》2025年第3期523-526,共4页Jilin Medical Journal

基　　金：“十三五”国家重点研发计划临床研究实验室[项目编号:2019YFF0216501]。

摘　　要：目的:探讨2型糖尿病(T2DM)患者发生骨质疏松(OP)危险因素及与血脂代谢的相关性。方法:按照简单随机原则选取2020年5月~2021年12月北京市隆福医院T2DM(T2DM组)患者及T2DM伴OP患者(T2DM+OP组)各200例。测量患者舒张压(DBP)、收缩压(SBP),全自动生化分析仪检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、钙(Ca)、磷(P),应用G7全自动糖化血红测定仪测定空腹血糖(FPG)、糖化血红蛋白(HbA1c),骨密度仪测腰椎侧位骨密度(BMD),放射免疫法(RIA)检测骨钙素(OC)、降钙素(CT)。结果:与T2DM组比较,T2DM+OP组TC、LDL-C水平及SBP显著升高,Ca、P、OC、CT水平显著降低,差异有统计学意义(P<0.05),但性别、年龄、体重指数(BMI)、T2DM病程、TG、DBP、餐后2 h血糖无统计学差异(P>0.05)。Logistics回归分析显示,LDL-C、TC、SBP、Ca、P、OC、CT是T2DM发生OP的影响因素。Pearson显示,血脂与BMD呈负相关(P<0.05);TC、LDL-C与Ca、P负相关(P<0.05),TG、HDL-C与Ca、P无相关(P<0.05);TC、LDL-C与OC、CT负相关(P>0.05),TG、HDL-C与OC、CT无相关(P>0.05)。结论:影响T2DM伴OP患者的危险因素复杂多样,应引起临床医生的重视,临床治疗中应根据患者实际情况干预治疗。Objective To analyze the risk factors of osteoporosis(OP)in patients with type 2 diabetes mellitus(T2DM)and its correlation with lipid metabolism.Methods A total of 200 T2DM patients and 200 T2DM patients with OP who visited the endocrinology department of Beijing Longfu Hospital between May 2020 and December 2021 were randomly selected and divided into the T2DM group and the T2DM+OP group.The patients′diastolic blood pressure(DBP)and systolic blood pressure(SBP)were measured.Total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),calcium(Ca),and phosphorus(P)levels were detected using a fully automated biochemical analyzer.Fasting plasma glucose(FPG)and glycated hemoglobin(HbA1c)levels were measured using a G7 fully automated glycated hemoglobin analyzer.Lumbar lateral bone density(BMD)was assessed using a bone densitometer,and osteocalcin(OC)and calcitonin(CT)levels were determined using the radioimmunoassay(RIA)method.Results Compared with the T2DM group,the T2DM+OP group showed significantly increased levels of TC,LDL-C,and SBP,and significantly decreased levels of Ca,P,OC,and CT(P<0.05).However,there were no significant differences in gender,age,body mass index(BMI),diabetes duration,TG,DBP,and 2-hour postprandial blood glucose between the two groups(P>0.05).Logistic regression analysis revealed that LDL-C,TC,SBP,Ca,P,OC,and CT were influencing factors for the occurrence of OP in T2DM patients.Pearson correlation analysis showed a negative correlation between blood lipids and BMD(P<0.05);specifically,TC and LDL-C were negatively correlated with Ca and P(P<0.05),while there were no significant correlation between TG,HDL-C and Ca and P(P>0.05).Additionally,there was a negative correlation between TC and LDL-C with OC and CT,but this was not statistically significant(P>0.05),and TG and HDL-C were not correlated with OC and CT(P>0.05).Conclusions The risk factors affecting T2DM patients with OP are complex and diverse,which should be given

关 键 词：2型糖尿病 骨质疏松 危险因素 血脂代谢 骨密度 

分 类 号：R587.1[医药卫生—内分泌]