2型糖尿病并发骨质疏松的相关危险因素分析

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1、2型糖尿病并发骨质疏松的相关危险因素分析作者：李小凤，施秉银，庞雅玲，王养维【摘要】　　目的分析2型糖尿病(T2DM)患者并发骨质疏松后骨密度(BMD)的改变及相关因素，为早期诊断、早期防治糖尿病并发骨质疏松提供理论依据。方法根据受试者的骨密度值将糖尿病患者分为骨质疏松组和非骨质疏松组，对比两组T2DM患者的性别、年龄、体重指数(BMI)、糖尿病病程、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)、胰岛素敏感指数(ISI)、尿白蛋白定量(ALb)、24h尿蛋白定量、血清钙、磷和碱性磷酸酶(

2、ALP)等指标之间的差异，并进行相关性分析。结果骨质疏松(OP)组与非OP组比较，OP组年龄大，病程长，体重指数低，骨密度低，碱性磷酸酶高，胰岛素敏感指数低，糖化血红蛋白高、空腹胰岛素低、24h尿蛋白定量和尿白蛋白定量高，t检验有统计学差异(P<0.05)；而空腹血糖、血磷、血钙值无统计学差异。T2DM患者的BMD与年龄、病程、糖化血红蛋白、24h尿蛋白定量、Alb、ALP负相关，与BMI、ISI正相关；与血钙、血磷、空腹血糖无相关性。结论高龄、低体重、病程长、血糖控制不良、胰岛功能差、胰岛素抵抗、高的血碱

3、性磷酸酶、糖尿病肾病都是糖尿病合并骨质疏松的危险因素。【关键词】2型糖尿病；骨密度；骨质疏松；危险因素10　　ABSTRACT:ObjectiveToinvestigatethechangesofbonemineraldensity(BMD)inpatientswithtype2diabetes(T2DM)complicatedwithosteoporosis(OP)andanalyzethefactorsrelatedtodiabeticosteoporosis(DOP)soastoprovidetheoret

4、icalevidenceforearlydiagnosisandpreventionofosteoporosiscomplicatedwithT2DM.MethodsAccordingtotheirBMDvalues,patientsweredividedintoOPgroupandnonOPgroup.Thenwecompareddifferencesinsex,age,bodymassindex(BMI),diabetesduration,fastingplasmaglucose(FPG),glycosyl

5、atedhemoglobin(HbA1c),fastinginsulin(FIns),insulinsensitivityindex(ISI),quantitativeofurinaryalbumin(ALb),quantitativeofurinaryproteinin24hours,serumcalcium(Ca),phosphorus(P)andalkaliphosphataselevel(ALP),andmadecorrelationanalysis.ResultsComparedwiththoseinn

6、onOPgroup,patientsinOPgrouphadolderage,longerdiseasecourse,smallerbaricindex,lowerbonedensity,higheralkaliphosphatase,lowerinsulinsensitivityindex,higherglycosylatedhemoglobin,higherquantitativeofurinaryproteinin24hoursandurinarymicroprotein,whichweresignifi

7、cantlydifferentaccordingtottest(P<0.05).However,thelevelsoffastingplasmaglucose,serumphosphorus10andserumcalciumdidnotdifferobviously.BMDoftype2diabeteswasnegativelycorrelatedtoage,diseasecourse,glycosylatedhemoglobin,quantitativeofurinaryproteinin24hours

8、,ALbandALP,butpositivelycorrelatedtoBMIandISI,andhadnocorrelationwithserumcalcium,serumphosphorusandfastingplasmaglucose.ConclusionManyfactors,suchasolderage,lowbodyweight,longdurationoft