CAJ | 학술논문

目的：横断面观察老年2型糖尿病（ type 2 diabetes mellitus，T2DM）患者骨密度及血尿酸水平，探讨两者之间的相关性。方法选择明确诊断为T2DM且年龄在60岁以上的患者254例，搜集患者资料，分别行骨密度测定，依据T值水平将患者分为骨量正常组（ n＝89例），骨量减少组（ n＝86例）及骨质疏松组（ osteoporosis，OP，n＝79例）；依据血尿酸水平将患者分为高尿酸血症组（血尿酸≥420μmol／L）和血尿酸正常组（血尿酸＜420μmol／L）。结果（1）老年T2DM男性患者血尿酸及各部位骨密度值均高于女性，OP患病率低于女性，差异具有统计学意义（ P＜0．05）。（2）男性患者血尿酸与腰椎1至4联合值（the lumbar vertebrae， L1－4）及Wards三角部位的骨密度呈正相关（r＝0．366， P＝0．009；r＝0．367， P＝0．008），女性患者血尿酸与各部位骨密度无明显相关性（P＞0．05）。（3）高尿酸血症组患者的血尿酸与股骨颈及大转子部位的骨密度呈负相关（r＝－0．374， P＝0．025；r＝－0．535， P＝0．001），血尿酸正常组血尿酸与股骨颈部位的骨密度呈正相关（r＝0．212， P＝0．010）。结论老年T2DM患者骨密度受性别及血尿酸水平的影响，正常偏高水平的血尿酸有利于稳定骨量。
목적：횡단면관찰노년2형당뇨병（ type 2 diabetes mellitus，T2DM）환자골밀도급혈뇨산수평，탐토량자지간적상관성。방법선택명학진단위T2DM차년령재60세이상적환자254례，수집환자자료，분별행골밀도측정，의거T치수평장환자분위골량정상조（ n＝89례），골량감소조（ n＝86례）급골질소송조（ osteoporosis，OP，n＝79례）；의거혈뇨산수평장환자분위고뇨산혈증조（혈뇨산≥420μmol／L）화혈뇨산정상조（혈뇨산＜420μmol／L）。결과（1）노년T2DM남성환자혈뇨산급각부위골밀도치균고우녀성，OP환병솔저우녀성，차이구유통계학의의（ P＜0．05）。（2）남성환자혈뇨산여요추1지4연합치（the lumbar vertebrae， L1－4）급Wards삼각부위적골밀도정정상관（r＝0．366， P＝0．009；r＝0．367， P＝0．008），녀성환자혈뇨산여각부위골밀도무명현상관성（P＞0．05）。（3）고뇨산혈증조환자적혈뇨산여고골경급대전자부위적골밀도정부상관（r＝－0．374， P＝0．025；r＝－0．535， P＝0．001），혈뇨산정상조혈뇨산여고골경부위적골밀도정정상관（r＝0．212， P＝0．010）。결론노년T2DM환자골밀도수성별급혈뇨산수평적영향，정상편고수평적혈뇨산유리우은정골량。
Objective To determine bone mineral density ( BMD) and the level of serum uric acid in senile patients with type 2 diabetes mellitus ( T2DM) through cross-sectional observation, and to investigate the relationship between them.Methods A total of 254 senile T2DM patients, who were definitely diagnosed and over 60 years old, were selected into this study.The clinical data were collected.BMD of all the patients was detected.The patients were divided into 3 groups according to T values: normal bone mass group (n=89), osteopenia group (n=86), and osteoporosis group (OP, n=79).In addition, they were also groupd on the basis of serum uric acid levels:high uric acid group ( blood uric acid≥420μmol/L) and normal group ( blood uric acid <420 μmol/L).Results The serum uric acid and BMD of each part in senile male T2DM patients were higher than those in female patients, while the incidence of OP was lower than that in female patients, and the difference was significant (P<0.05).In male patients, the serum uric acid level was positively correlated with BMD of L1-4 and the Wards triangle (r=0.366, P=0.009;r=0.367, P=0.008).But no significant correlation was in female patients (P>0.05).In high uric acid group, the serum uric acid level was negatively correlated with BMD of the femoral neck and the greater trochanter (r=-0.374, P=0.025;r=-0.535, P=0.001) .However, in normal uric acid group, the serum uric acid level was positively correlated with BMD of the femoral neck (r=0.212, P=0.010).Conclusion BMD in senile T2DM patients was affected by gender and serum uric acid levels.The high-normal levels of serum uric acid are useful to stable BMD.