中国骨质疏松杂志
中國骨質疏鬆雜誌
중국골질소송잡지
CHINESE JOURNAL OF OSTEOPOROSIS
2015年
5期
603-606
,共4页
黄薇%陈芳%李茂蓉%刘英
黃薇%陳芳%李茂蓉%劉英
황미%진방%리무용%류영
老年%2型糖尿病%骨质疏松%维生素D
老年%2型糖尿病%骨質疏鬆%維生素D
노년%2형당뇨병%골질소송%유생소D
Elderly%Type 2 diabetes%Osteoporosis%Vitamin D
目的：通过对我科住院的118名老年2型糖尿病患者生化指标、骨密度（ BMD）及维生素D水平的检测，分析探讨此类患者骨质疏松的危险因素及与骨密度的相关关系。方法选取2011年3月至2012年6月在我院内分泌科住院的2型糖尿病患者118例，男性55例，女性63例，年龄50－89岁，平均年龄63．92±9．26岁。所有入选女性均已停经1年以上。空腹血检测糖化血红蛋白、血糖、血钙、磷、生化及维生素D，双能X线骨密度测定。根据BMD分组：受检部位只要有一个或一个以上的T值≤－2．5SD，或－2．5 SD ＜T≤－1．0 SD，或T ＞－1．0 SD分别诊断为骨质疏松；骨量减少；骨量正常。根据25（OH）D水平，≥30 ng／ml为维生素D充足；≥20 ng／ml且＜30 ng／ml为不足；≥10 ng／ml且＜20 ng／ml为缺乏，＜10 ng／ml为严重缺乏。结果根据WHO骨质疏松诊断标准，本研究患者骨质疏松或骨量减少达到78％。骨质疏松组年龄显著大于骨量减少及骨量正常组；体重指数（ BMI）显著小于骨量减少及骨量正常组。三组之间FBS、HbA1c、血钙、磷、血脂及维生素D水平均无统计学差异。维生素D不足占6．9％，缺乏占73．7％，严重缺乏占16．9％。 Pearsen和Spearman’ s相关分析显示：腰椎BMD与BMI呈正相关（r＝0．345，P＜0．01），与TC、LDL-c、HDL-c呈负相关（r＝－0．27，－0．20，－0．19，P＜0．05）。股骨颈BMD与年龄呈负相关（ r＝－0．24，P＜0．01）。血钙、磷、FBS、HbA1c、甘油三脂与各部位骨密度均无相关性。维生素D水平与血钙呈显著正相关（r＝0．415，P＜0．01），与HbA1c呈负相关（r＝－0．265，P＜0．01）。维生素D水平与各部位BMD均无相关性。结论增龄及体重指数偏低，同样是老年2型糖尿病骨质疏松的重要危险因素；脂代谢及糖代谢紊乱对骨密度负面的影响作用也应引起重视；维生素D缺乏在这一人群当中更加严重。
目的：通過對我科住院的118名老年2型糖尿病患者生化指標、骨密度（ BMD）及維生素D水平的檢測，分析探討此類患者骨質疏鬆的危險因素及與骨密度的相關關繫。方法選取2011年3月至2012年6月在我院內分泌科住院的2型糖尿病患者118例，男性55例，女性63例，年齡50－89歲，平均年齡63．92±9．26歲。所有入選女性均已停經1年以上。空腹血檢測糖化血紅蛋白、血糖、血鈣、燐、生化及維生素D，雙能X線骨密度測定。根據BMD分組：受檢部位隻要有一箇或一箇以上的T值≤－2．5SD，或－2．5 SD ＜T≤－1．0 SD，或T ＞－1．0 SD分彆診斷為骨質疏鬆；骨量減少；骨量正常。根據25（OH）D水平，≥30 ng／ml為維生素D充足；≥20 ng／ml且＜30 ng／ml為不足；≥10 ng／ml且＜20 ng／ml為缺乏，＜10 ng／ml為嚴重缺乏。結果根據WHO骨質疏鬆診斷標準，本研究患者骨質疏鬆或骨量減少達到78％。骨質疏鬆組年齡顯著大于骨量減少及骨量正常組；體重指數（ BMI）顯著小于骨量減少及骨量正常組。三組之間FBS、HbA1c、血鈣、燐、血脂及維生素D水平均無統計學差異。維生素D不足佔6．9％，缺乏佔73．7％，嚴重缺乏佔16．9％。 Pearsen和Spearman’ s相關分析顯示：腰椎BMD與BMI呈正相關（r＝0．345，P＜0．01），與TC、LDL-c、HDL-c呈負相關（r＝－0．27，－0．20，－0．19，P＜0．05）。股骨頸BMD與年齡呈負相關（ r＝－0．24，P＜0．01）。血鈣、燐、FBS、HbA1c、甘油三脂與各部位骨密度均無相關性。維生素D水平與血鈣呈顯著正相關（r＝0．415，P＜0．01），與HbA1c呈負相關（r＝－0．265，P＜0．01）。維生素D水平與各部位BMD均無相關性。結論增齡及體重指數偏低，同樣是老年2型糖尿病骨質疏鬆的重要危險因素；脂代謝及糖代謝紊亂對骨密度負麵的影響作用也應引起重視；維生素D缺乏在這一人群噹中更加嚴重。
목적：통과대아과주원적118명노년2형당뇨병환자생화지표、골밀도（ BMD）급유생소D수평적검측，분석탐토차류환자골질소송적위험인소급여골밀도적상관관계。방법선취2011년3월지2012년6월재아원내분비과주원적2형당뇨병환자118례，남성55례，녀성63례，년령50－89세，평균년령63．92±9．26세。소유입선녀성균이정경1년이상。공복혈검측당화혈홍단백、혈당、혈개、린、생화급유생소D，쌍능X선골밀도측정。근거BMD분조：수검부위지요유일개혹일개이상적T치≤－2．5SD，혹－2．5 SD ＜T≤－1．0 SD，혹T ＞－1．0 SD분별진단위골질소송；골량감소；골량정상。근거25（OH）D수평，≥30 ng／ml위유생소D충족；≥20 ng／ml차＜30 ng／ml위불족；≥10 ng／ml차＜20 ng／ml위결핍，＜10 ng／ml위엄중결핍。결과근거WHO골질소송진단표준，본연구환자골질소송혹골량감소체도78％。골질소송조년령현저대우골량감소급골량정상조；체중지수（ BMI）현저소우골량감소급골량정상조。삼조지간FBS、HbA1c、혈개、린、혈지급유생소D수평균무통계학차이。유생소D불족점6．9％，결핍점73．7％，엄중결핍점16．9％。 Pearsen화Spearman’ s상관분석현시：요추BMD여BMI정정상관（r＝0．345，P＜0．01），여TC、LDL-c、HDL-c정부상관（r＝－0．27，－0．20，－0．19，P＜0．05）。고골경BMD여년령정부상관（ r＝－0．24，P＜0．01）。혈개、린、FBS、HbA1c、감유삼지여각부위골밀도균무상관성。유생소D수평여혈개정현저정상관（r＝0．415，P＜0．01），여HbA1c정부상관（r＝－0．265，P＜0．01）。유생소D수평여각부위BMD균무상관성。결론증령급체중지수편저，동양시노년2형당뇨병골질소송적중요위험인소；지대사급당대사문란대골밀도부면적영향작용야응인기중시；유생소D결핍재저일인군당중경가엄중。
Objective To determine the relationship between osteoporosis and bone mineral density ( BMD) and the risk factors for osteoporosis by studying serum biochemical index in 118 elderly patients with type 2 diabetes in our department.Methods A total of 118 elderly patients with type 2 diabetes were randomly selected from March 2011 to June 2012 in the Department of Endocrinology in the hospital, including 55 males and 63 females, aging from 50 to 89 years old, with a mean age of 63.92 ±9.26 years.All the women were at least 1 year after menopause.Fasting blood sample were collected to determine glycosylated hemoglobin, blood sugar, blood biochemical parameters, vitamin D, calcium, phosphorus.BMD were determined using dual energy X-ray absorptiometry.According to BMD, osteoporosis group (T value≤ -2.5 SD), osteopenia group (-2.5 SD <T≤ -1.0 SD), and normal bone mass group (T >-1.0 SD) were divided.According to the serum 25 (OH) D level, sufficiency group (≥30 ng/ml), insufficiency group (≥20 ng/ml and <30 ng/ml), deficiency group (≥10 ng/ml and -<20 ng/ml), severe deficiency group (<10ng/ml) were divided.Results ccording to the WHO criteria, in this study patients with osteoporosis or bone loss were up to 78%.The age of patients in the osteoporosis group was significantly older than that in the bone loss and the normal bone mass group;Body mass index ( BMI) of in the osteoporosis group was significantly lower than that in the bone loss and bone mass normal group. Among the three groups, FBS, HbA1c, blood calcium, phosphorus, blood lipid, and vitamin D level were not statistically different. The prevalence of vitamin D insufficiency, deficiency, and severe deficiency was 6.9%, 73.7%, and 16.9%, respectively.Pearson and Spearman’ s correlation analysis showed that lumbar BMD was positively correlated with BMI, but negatively correlated with TC, LDL-c, and HDL-c.BMD of the femoral neck was negatively correlated with age.Calcium, phosphorus, FBS, HbA1c, and blood triglycerides were not correlated with BMD of any location.Vitamin D level was positively and significantly correlated with blood calcium (r =0.415, P<0.01), but negatively correlated with HbA1c (r =0.265, P<0.01).Vitamin D level was not correlated with BMD of any location.Conclusion Older age and lower BMI are the important risk factors for osteoporosis in elderly with type 2 diabetes.We should pay attention to the negative effects of metabolic disorder of lipid and glucose on bone mineral density.Vitamin D deficiency among this group is more serious.
