2017 年第 10 期 第 12 卷

2型糖尿病患者脂代谢指标变化对骨质疏松发生的影响

Effect of lipid metabolism indicators on occurrence of osteoporosis in patients with type 2 diabetes mellitus

作者：班安然陶红

英文作者：Ban Anran Tao Hong

单位：100029首都医科大学附属北京安贞医院内分泌代谢科

英文单位：Department of Endocrinology and Metabolism Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：糖尿病，2型；骨质疏松；脂质代谢

英文关键词：Diabetesmellitus,type2;Osteoporosis;Lipidmetabolism

• 摘要：

• 目的 分析2型糖尿病患者脂代谢指标变化对骨质疏松发生的影响。方法 选取2016年1—7月首都医科大学附属北京安贞医院收治的2型糖尿病伴有骨质疏松患者86例作为观察组。另选取同期2型糖尿病不伴有骨质疏松患者86例作为对照组。记录2组患者一般资料，检测骨密度、血糖、血脂及高敏C反应蛋白等实验室指标，并采用Logistic回归方法分析2型糖尿病患者脂代谢指标变化对骨质疏松发生的影响。结果 观察组患者平均年龄大于对照组［(59±3)岁 比(52±4)岁］，男性比例和体重指数小于对照组［36.0%（31/86）比40.7%（35/86）、(24.2±2.3)kg/m2比(26.4±2.0)kg/m2］，差异均有统计学意义(均P＜0.05)。观察组收缩压、舒张压水平与对照组比较，差异均无统计学意义(均P＞0.05)。观察组空腹血糖、餐后2 h血糖、三酰甘油、高密度脂蛋白胆固醇、高敏C反应蛋白水平与对照组比较，差异均无统计学意义（均P＞0.05）。观察组总胆固醇和低密度脂蛋白胆固醇水平明显高于对照组［(5.9±0.9) mmol/L比（5.2±0.9）mmol/L、(3.6±0.7)mmol/L比（3.2±0.6）mmol/L］，差异均有统计学意义（均P＜0.05）。Logistic回归方法分析显示，低密度脂蛋白胆固醇是2型糖尿病患者伴发骨质疏松的危险因素(比值比=2.449，95%置信区间：1.102～5.385， P=0.031)。 结论 2型糖尿病患者低密度脂蛋白胆固醇变化影响骨质疏松的发生。

• Objective To analyze the effect of changes of lipid metabolism indicators on occurrence of osteoporosis in patients with type 2 diabetes mellitus. Methods From January to July 2016, 86 cases of type 2 diabetic patients with osteoporosis were enrolled as observation group and 86 cases of type 2 diabetic patients without osteoporosis were enrolled as control group in Beijing Anzhen Hospital, Capital Medical University. Age, sex, body mass index, blood pressure, bone density, blood glucose, blood lipid and high-sensitivity C-reactive protein were recorded. The relation between lipid metabolism indicators and osteoporosis was analyzed by logistic regression. Results The average age in observation group was significantly higher, male ratio and body mass index were significantly lower than those in control group［（59±3）years vs （52±4）years, 36.0%（31/86） vs 40.7%（35/86）, （24.2±2.3）kg/m2 vs （26.4±2.0）kg/m2］（P＜0.05）. Systolic and diastolic blood pressure, fasting and postprandial 2 h blood glucose, triacylglycerol, high-density lipoprotein cholesterol and high-sensitivity C-reactive protein had no significant differences between groups（P＞0.05）. Total cholesterol and low-density lipoprotein cholesterol in observation group were significantly higher than those in control group［（5.9±0.9）mmol/L vs （5.2±0.9）mmol/L, （3.6±0.7）mmol/L vs （3.2±0.6）mmol/L］（P＜0.05）. Logistic regression analysis showed that low-density lipoprotein cholesterol was a risk factor of osteoporosis in patients with type 2 diabetes（odds ratio ＝2.449, 95% confidence interval: 1.102-5.385, P＝0.031）. Conclusion Low-density lipoprotein cholesterol has influence on the occurrence of osteoporosis in patients with type 2 diabetes mellitus.