老年2型糖尿病女性骨质疏松状况及其影响因素

被引：28

作者：

陈海翎 ^{[1
]}

李菊芬 ^{[1
]}

王倩 ^{[1
]}

邓丽丽 ^{[1
]}

吕艳伟 ^{[2
]}

机构：

[1] 北京积水潭医院内分泌科

[2] 北京积水潭医院临床统计与流行病研究室

来源：

中华糖尿病杂志 | 2016年 / 8卷 / 08期

关键词：

糖尿病, 2型; 骨密度; 骨质疏松; 骨质丢失;

D O I：

暂无

中图分类号：

R580 []; R587.2 [糖尿病性昏迷及其他并发症];

学科分类号：

100201 [内科学];

摘要：

目的探讨老年2型糖尿病(T2DM)女性骨质疏松状况及影响因素。方法 2011年1月到2012年2月入组167例老年T2DM女性患者及138名老年健康女性(对照组)。对两组受试者进行健康问卷调查, 并检测其骨密度(BMD)和生化、骨代谢指标。应用多因素Logistic回归、多元相关与回归分析该人群骨质疏松情况及其影响因素。结果 T2DM组167例, 年龄60～78岁;对照组138例, 年龄60～ 80岁。老年T2DM女性骨量减低和骨质疏松者共占85.6%(143/167), 显著低于对照组的97.1% (134/138)(χ2=11.929, P=0.001)。T2DM组发生低骨量和骨折的风险分别是对照组的0.178倍和1.776倍。以骨量减低为因变量, 锻炼频率、锻炼年限和体质指数(BMI)进入多因素Logistic回归方程, 回归系数为:-0.438、-0.840、-0.297, 均P<0.05。T2DM未进入该方程但进入了以骨折为因变量的多因素Logistic回归方程。T2DM组酒石酸酸性磷酸酶5b、尿羟脯氨酸/肌酐比值显著高于对照组(校正BMI和生活方式后F=3.818、1.541, 均P<0.05), 而骨钙素和骨特异性碱性磷酸酶则显著低于对照组(校正BMI和生活方式后F=0.407、0.920, 均P<0.05)。结论老年T2DM女性发生低骨量的风险低于对照组, 但骨折发生率高;其骨代谢特征是骨吸收增加且骨形成减少, 症状则更加隐匿。

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