2型糖尿病患者合并骨量减少的危险因素分析.docx
2型糖尿病患者合并骨量减少的危险因素分析陈璐钱凤娟张敏表1两组研究指标比较组别性别例（ ） |年龄病程EBG(年)(mmol/L )HbAlc(%)TGTC(mniol/L )( mmol/L )男女（岁）计收正常组（n=103）64 (62.1 )39 ( 37.9 ) 5858 ± 12.23 7.95 ± 1328.65 ± 2.489.83 ± 2.832.58 ±0.924.51 ± 1.06骨量减少组（”197）121 (61.4)76 (38.6) 56.69 ± 12.50 7.91 ± 1.918.33 ± 2.229.69 ±3.712.43 ± 0.964.66 ± 1.30，值0.0151.2580.332-0.781-1.0321.303-1.188“值0.9040.2100.3690.43503020.0960.235表1（续）组别LDL-C ( mmol/L )HDL-C ( mmol/L )吸烟史 | 例(% )饮酒史例( ) )SBP ( mmHg )骨量正常组（“103）2.41 ±0.661.03 ±0.2831 (30.10)18 ( 17.47)139.45 ± 18.35骨量:减少组（n=197）2.49 ±0.931.05 ±0.23111( 5635 )25 ( 12.69)143.40 ±72.58值-0.549136318.6931.261-0.282Pifi0.5830.173<0.0010.2610.778表1（续）组别DBP ( mmHg )BMI ( kg/m2)USUI (cm)腰腰比商尿蛋白/肌府例（）骨址正常组（”103）8531 ± 10.8024.20 ±3.9187.26 ± 10.410.91 ±0.0610 (9.71 )骨量减少组（n=l97）83.66 ± 11.2025.33 ±3.5890.97 ± 10.330.93 ± 0.0652 (26.40)X%值-1.352-3.315-3.117-2.66811.487值0.1760.0() 10.0020.008<0.001表1（续）组别糖尿病视网膜病变例（）ALP ( U/L)UA ( |imol/lj钙(mmol/L )骨量正常组（n=103）2() ( 19.41 )6231 ±5.76330.97 ±53.632.23 ± 0.26骨量减少组g97）49 ( 24.87)78.68 ± 733313.63 ±50.632.21 ±0.21值1.68719.7012.7590.720。值0.194<0.001O.(X)30.235表2 2型糖尿病患者合并骨量减少的危险因素分析研究指标BSEWald (ftP 值OR (fl95%C7BM10.056().01014.560<0.051.0571.02(). 2.698腹圈0.0360.0138.070<0.051.0371.01 L 1.063吸烟史0.0730.02013.322<0.051.0761.05 L 3.016尿蛋A /肌酊0.1130.03113.286<0.051.1191.066. 3.791ALP0.0790.01917,280<0.051.0821.039. 3.033UA0.0510.01610.156<0.051.0521.016. 25932018年8月本院的300例2型糖尿病患者研究对象，将其根据骨量的不同分为骨量正常组（n=103）和骨量减少组（n=197） o比较两组性别、年龄、病程、BMI、腹围、腰臀比、FBG、HbAlc、脂代谢指标（TG、TC、LDL-C及HDL-C）、吸烟史、饮酒史、SBP、DBP、高尿蛋白/肌酎、糖尿病视网膜病变、血清ALP、UA及钙，采用多因素logistic回归分析处理2型糖尿病患者合并骨量减少的危险因素。结果：两组性别、年龄、病程、FBG、HbAlc、脂代谢指标、饮酒史、SBP、DBP、糖尿病视网膜病变情况及血清钙比较，差异均无统计学意义（P0.05）；两组BMI、腹围、腰臀比、吸烟史、高尿蛋白/肌酎及血清ALP、UA比较，差异均有统计学意义(P<0. 05)。多因素logistic回归分析显示，BMI、腹围、吸烟史、尿蛋白/肌酎及ALP、UA均是2型糖尿病患者合并骨量减少的危险因素(P<0.05) o结论：2型糖尿病患者合并骨量减少的危险因素涉及BMI、腹围、吸烟史、尿蛋白/肌酎、ALP及UA,应重视对2型糖尿病患者上述因素的监测、评估与调控。Key 2型糖尿病骨量减少危险因素Analysis on Risk Factors of Patients with Type 2 Diabetes Mellitusand Osteopenia/CHEN Lu, QIAN Fengjuan, ZHANG Min. /MedicalInnovation of China, 2021, 18 (35) ： 0-034Abstract Objective： To investigate and analyze the risk factors ofpatients with type 2 diabetes mellitus and osteopenia. Method： Atotal of 300 patients with type 2 diabetes mellitus from February2016 to August 2018 were chosen as the study objects, and they weredivided into normal bone mass group (n=103) and osteopenia group(n=197) according to the differences of bone mass. Then thegender, ages, disease course, BMI, abdominal circumference,waist-hip ratio, FBG, HbAlc, lipid metabolism indexes (TG, TC,LDL-C and HDL-C) , smoking history, drinking history, SBP, DBP,high urinary protein/creatinine and diabetic retinopathy and serumALP, UA and calcium of two groups were compared, and the riskfactors of osteopenia in patients with type 2 diabetes mellitus wereanalyzed with multivariate logistic regression analysis. Result： Thegender, ages, disease course, FBG, HbAlc, lipid metabolismindexes, drinking history, SBP, DBP, diabetic retinopathy andserum calcium of two groups were compared, there were nostatistically significant differences (P>0.05) ； the BML abdominalcircumference, waist-hip ratio, smoking history, high urinaryprotein/creatinine and serum ALP, UA of two groups were compared,there were statistically significant differences (P<0. 05) . Themultivariate logistic regression analysis showed BMI, abdominalcircumference, smoking history, urinary protein/creatinine, ALPand UA were the risk factors of patients with type 2 diabetesmellitus and osteopenia (P<0. 05) . Conclusion： The risk factors ofpatients with type 2 diabetes mellitus and osteopenia include BMI,abdominal circumference, smoking history, urinaryprotein/creatinine, ALP and UA, so those factors of patients withtype 2 diabetes mellitus should be paid to more monitoring,evaluation and regulation.Key words Type 2 diabetes mellitus Osteopenia Risk factorsFirst-author, s address： The Third Affiliated Hospital of SoochowUniversity (The First People' s Hospital of Changzhou) , Changzhou213000, Chinadoi： 10. 3969/j. issn. 1674-4985. 2021. 35.0082型糖尿病在我国临床具有较高的发病率，而本病患者的较多方面呈现代谢异常的状态。近年来，临床中关于糖尿病患者骨代谢异常的研究不断增多，较多研究认为，2型糖尿病患者的骨量异常情况发生率相对较高，导致本类患者骨质疏松及相关骨折发生的危险程度增高因此对2型糖尿病患者进行早期骨量减少的防控需求较高。而对2型糖尿病患者骨量减少危险因素的研究与掌握是改善预后的重要基础条件与前提。因此，本研究就2型糖尿病患者合并骨量减少的危险因素进行探究与分析，为临床防治管理提供思路和依据。现报道如下。1资料与方法1. 1 一般资料 选取2016年2月-2018年8月本院的300例2型糖尿病患者为研究对象。纳入标准：所有患者均确诊为2型糖尿病；对研究积极配合；临床资料完整。排除标准：合并其他可导致骨质疏松的疾病；存在导致骨质代谢异常的疾病；1个月内应用激素。以T值为TW且1为骨量正常，而T值T为骨量减少3。将患者根据骨量的不同分为骨量正常组（n=103）
