中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
10期
867-871
,共5页
糖尿病,2型%骨密度%腹内脂肪%视黄醇结合蛋白质类
糖尿病,2型%骨密度%腹內脂肪%視黃醇結閤蛋白質類
당뇨병,2형%골밀도%복내지방%시황순결합단백질류
Diabetes mellitus,type 2%Bone density%Intra-abdominal fat%Retinol-binding proteins
目的 探讨腹腔脂肪面积(VAT)与绝经后2型糖尿病患者骨密度的关系以及血清视黄醇结合蛋白4(RBP4)与骨密度的相关性. 方法 收集2010年9月至2011年6月于我院内分泌科住院治疗的绝经后2型糖尿病患者69例,年龄40～73岁.应用CT测量VAT及腹部皮下脂肪面积(SAT),应用双能X线骨密度测定仪测量骨密度(g/cm2);根据体质指数(BMI)均值及VAT均值分为1～4组,组1:BMI＜26.0 kg/m2,VAT＜155.3 cm2;组2:BMI＜26.0 kg/m2,VAT＞ 155.3 cm2;组3:BMI＜26.0kg/m2,VAT＜155.3 cm2;组4:BMI＜26.0 kg/m2,VAT＞155.3 cm2. 结果 绝经后2型糖尿病患者VAT与腰椎、大转子区骨密度呈负相关(r=-0.367,r=-0.301),在控制BMI、SAT对骨密度的影响后,VAT与女性绝经后2型糖尿病患者腰椎、大转子区、股骨颈及转子间骨密度均呈负相关(r分别为-0.433、-0.432、-0.300、-0.297,均P＜0.05).LNRBP4与腰椎骨密度呈负相关(r=-0.295,P＜0.05).组间比较显示,组3腰椎骨密度(1.00±0.20比0.79±0.14)、股骨颈骨密度(0.82±0.17比0.70±0.10)、转子间骨密度(1.13±0.24比0.95±0.14)、大转子区骨密度(0.76±0.18比0.58±0.11)均高于组2(P＜0.05).对各部位骨密度所拟合的多元线性回归方程中,腰椎骨密度、股骨颈骨密度、转子间骨密度、大转子区骨密度能被自变量(年龄、糖尿病病程、BMI、VAT、糖化血红蛋白、空腹血浆胰岛素、绝经时间)的变异解释分别占51.7％、52.2％、59.8％、75.3％(均P＜0.01). 结论 局部脂肪对绝经后2型糖尿病患者骨密度的影响可能取决于脂肪的分布类型,VAT是绝经后2型糖尿病患者骨密度的独立预测因子;血清RBP4可能有助于解释VAT对2型糖尿病患者骨密度的影响.
目的 探討腹腔脂肪麵積(VAT)與絕經後2型糖尿病患者骨密度的關繫以及血清視黃醇結閤蛋白4(RBP4)與骨密度的相關性. 方法 收集2010年9月至2011年6月于我院內分泌科住院治療的絕經後2型糖尿病患者69例,年齡40～73歲.應用CT測量VAT及腹部皮下脂肪麵積(SAT),應用雙能X線骨密度測定儀測量骨密度(g/cm2);根據體質指數(BMI)均值及VAT均值分為1～4組,組1:BMI＜26.0 kg/m2,VAT＜155.3 cm2;組2:BMI＜26.0 kg/m2,VAT＞ 155.3 cm2;組3:BMI＜26.0kg/m2,VAT＜155.3 cm2;組4:BMI＜26.0 kg/m2,VAT＞155.3 cm2. 結果 絕經後2型糖尿病患者VAT與腰椎、大轉子區骨密度呈負相關(r=-0.367,r=-0.301),在控製BMI、SAT對骨密度的影響後,VAT與女性絕經後2型糖尿病患者腰椎、大轉子區、股骨頸及轉子間骨密度均呈負相關(r分彆為-0.433、-0.432、-0.300、-0.297,均P＜0.05).LNRBP4與腰椎骨密度呈負相關(r=-0.295,P＜0.05).組間比較顯示,組3腰椎骨密度(1.00±0.20比0.79±0.14)、股骨頸骨密度(0.82±0.17比0.70±0.10)、轉子間骨密度(1.13±0.24比0.95±0.14)、大轉子區骨密度(0.76±0.18比0.58±0.11)均高于組2(P＜0.05).對各部位骨密度所擬閤的多元線性迴歸方程中,腰椎骨密度、股骨頸骨密度、轉子間骨密度、大轉子區骨密度能被自變量(年齡、糖尿病病程、BMI、VAT、糖化血紅蛋白、空腹血漿胰島素、絕經時間)的變異解釋分彆佔51.7％、52.2％、59.8％、75.3％(均P＜0.01). 結論 跼部脂肪對絕經後2型糖尿病患者骨密度的影響可能取決于脂肪的分佈類型,VAT是絕經後2型糖尿病患者骨密度的獨立預測因子;血清RBP4可能有助于解釋VAT對2型糖尿病患者骨密度的影響.
목적 탐토복강지방면적(VAT)여절경후2형당뇨병환자골밀도적관계이급혈청시황순결합단백4(RBP4)여골밀도적상관성. 방법 수집2010년9월지2011년6월우아원내분비과주원치료적절경후2형당뇨병환자69례,년령40～73세.응용CT측량VAT급복부피하지방면적(SAT),응용쌍능X선골밀도측정의측량골밀도(g/cm2);근거체질지수(BMI)균치급VAT균치분위1～4조,조1:BMI＜26.0 kg/m2,VAT＜155.3 cm2;조2:BMI＜26.0 kg/m2,VAT＞ 155.3 cm2;조3:BMI＜26.0kg/m2,VAT＜155.3 cm2;조4:BMI＜26.0 kg/m2,VAT＞155.3 cm2. 결과 절경후2형당뇨병환자VAT여요추、대전자구골밀도정부상관(r=-0.367,r=-0.301),재공제BMI、SAT대골밀도적영향후,VAT여녀성절경후2형당뇨병환자요추、대전자구、고골경급전자간골밀도균정부상관(r분별위-0.433、-0.432、-0.300、-0.297,균P＜0.05).LNRBP4여요추골밀도정부상관(r=-0.295,P＜0.05).조간비교현시,조3요추골밀도(1.00±0.20비0.79±0.14)、고골경골밀도(0.82±0.17비0.70±0.10)、전자간골밀도(1.13±0.24비0.95±0.14)、대전자구골밀도(0.76±0.18비0.58±0.11)균고우조2(P＜0.05).대각부위골밀도소의합적다원선성회귀방정중,요추골밀도、고골경골밀도、전자간골밀도、대전자구골밀도능피자변량(년령、당뇨병병정、BMI、VAT、당화혈홍단백、공복혈장이도소、절경시간)적변이해석분별점51.7％、52.2％、59.8％、75.3％(균P＜0.01). 결론 국부지방대절경후2형당뇨병환자골밀도적영향가능취결우지방적분포류형,VAT시절경후2형당뇨병환자골밀도적독립예측인자;혈청RBP4가능유조우해석VAT대2형당뇨병환자골밀도적영향.
Objective To determine the associations of visceral adipose tissue area and retinol binding protein 4(RBP4) with bone mineral density (BMD) in the postmenopausal patients with type 2 diabetes mellitus (T2DM).Methods The cross-sectional study involved 69 postmenopausal patients with T2DM (aged 40-73 years) in our hospital,they were divided into 4 groups:group 1:BMI ＜26.0 kg/m2,VAT＜ 155.3 cm2 ; group 2:BMI ＜ 26.0 kg/m2,VAT＞ 155.3 cm2 ; group 3:BMI ＜26.0 kg/m2,VAT＜155.3 cm2;group 4:BMI＜26.0 kg/m2,VAT＞155.3 cm2.The visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area were obtained by computed tomography(CT) and BMD was measured by dual energy X-ray absorptiometry (DEXA).Results VAT area had negative associanons with lumbar spine BMD (LS-BMD) and greater trochanter BMD (GT-BMD) (r=-0.367,r=-0.301),and with LS-BMD,GT-BMD,femoral neck BMD (FN-BMD) and intertrochanter BMD (IT-BMD) even after adjusting for body mass index(BMI) and SAT (r =-0.433,-0.432,-0.300,-0.297,all P＜0.05).A negative relationship was showed between LNRBP4 and LS-BMD in postmenopausal female patients (all P ＜ 0.05.) The postmenopausal female patients with T2DM were divided into four groups according to the mean values of BMI and VAT area.BMD at any site of group 3(LS-BMD:1.00±0.20,FN-BMD:0.82±0.17,IT-BMD:1.13±0.21,GT-BMD:0.76±0.18) were higher than group 2(0.79±0.14,0.70±0.10,0.95±0.14,0.58±0.11).The multiple regression indicated that the variation of predictors (age,DUR,BMI,VAT,HbA1c,FINS and PMT) explained 51.7％,52.2％,59.8％ and 75.3％ of the variation in LS-BMD.FN-BMD,IT-BMD,GT-BMD among subjects,respectively(all P＜0.01).Conclusions The influence of fat on bone density may depend on its site of VAT or SAT.VAT could be an independent determinant factor of BMDin the postmenopausal female with T2DM.Serum RBP4 may contribute to this effect.
