2型糖尿病患者骨量异常的危险因素分析

发布时间：2018-01-19 20:43

本文关键词： 2型糖尿病骨量异常危险因素　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对2型糖尿病与2型糖尿病合并骨量异常的对比,研究2型糖尿病患者骨量异常的有关危险因素并进行分析;为糖尿病患者提高生存质量,预防骨质疏松的发生发展,减少患者骨折的发生及减少经济负担,提供科学依据。方法:抽取新疆生产建设兵团医院2015年6月-2016年9月入院的1110名2型糖尿病患者进行调查,检测骨密度。其中糖尿病合并骨量异常者为655人,单纯2型糖尿病者为445人,把糖尿病伴骨量异常(骨量减少和骨质疏松)者作为病例组,骨量正常者作为对照组。收集患者一般情况包括:年龄、性别、吸烟、血压、体重指数(BMI),及生化指标包括:空腹血糖(FPG)、胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、钙(Ca)、磷(P)、糖化血红蛋白(HbA1c)、尿素氮(BUN)、肌酐(Cr)、空腹胰岛素水平(FINS),糖尿病微血管并发症等指标。对以上患者一般情况、生化指标及糖尿病相关并发症进行对比分析,采用spss20.0统计软件进行数据分析,计量资料符合正态分布的使用χ±s表示,两组均数之间比较用t检验;不符合正态分布的使用中位数和四分位间距描述,组间比较采用非参数检验;计数资料采用频数描述,组间比较采用χ~2检验,使用非条件Logistic回归进行影响因素的分析,以P0.05有统计学差异。结果:1)糖尿病合并骨量异常组中,年龄低于49岁的男性人数占31.8%、女性人数占32.0%;50~59岁的男性人数占68.3%、女性人数占78.4%;60~69岁的男性人数占50.7%、女性人数占91.6%;年龄70岁的男性人数占72.5%、女性人数占83.2%。在糖尿病组中年龄49岁的男性人数占68.2%、女性人数占68%,50~59岁男性人数占31.7%、女性人数占21.6%,60~69岁男性人数占49.3%、女性人数占8.4%,年龄70的男性人数占27.5%、女性人数占16.8%;2)两组间比较,在年龄、病程、BMI、收缩压、性别、吸烟等因素方面存在统计学意义(P0.05),其中,2型糖尿病合并骨量异常组患者的年龄、病程、收缩压高于糖尿病组,BMI低于2型糖尿病组(P0.05)。糖尿病并发肾病、视网膜病变、神经病变时,糖尿病合并骨量异常的发生明显增加,且有统计学意义(P0.001);3)糖尿病合并骨量异常组的FPG、HbA1c大于糖尿病组,两组有统计学意义(P0.01,P0.05),糖尿病组的FINS、Cr、TG大于病例组,两组有统计学意义(P0.01,P0.05),在男性中糖尿病合并骨量异常组的FPG、Cr、HbA1c大于糖尿病组,两组有统计学意义(P0.01,P0.05),糖尿病组的FINS、LDL大于病例组,两组有统计学意义(P0.01,P0.05)。在女性中糖尿病合并骨量异常组的FPG、HbA1c大于糖尿病组,两组有统计学意义(P0.01);4)随着年龄及病程的增加,2型糖尿病患者中骨量异常的发病率逐渐增高,年龄大于50岁以上者,无论男性还是女性骨量异常的发生率明显增加,且女性高于男性,两组相比有统计学意义(P0.05);5)使用logistics回归分析发现:年龄、女性、病程、吸烟、高血糖、高糖化血红蛋白及糖尿病并发症(视网膜、神经病变、肾病)是糖尿病并骨量异常的危险因素。结论:年龄、吸烟、病程、BMI、血糖、糖化血红蛋白、糖尿病并发症以及性别是2型糖尿病合并骨量异常患者的主要独立危险因素。
[Abstract]:Objective: through the comparison of type 2 diabetes and type 2 diabetes mellitus complicated with abnormal bone mass, bone mass of related risk factors in patients with type 2 diabetes and abnormal analysis; improve the quality of life for patients with diabetes, the occurrence and development of osteoporosis prevention, reduce the incidence and reduce the economic burden of patients with fracture, and provide a scientific basis. Methods: 1110 patients with type 2 diabetes from Xinjiang production and Construction Corps Hospital in June 2015 -2016 year in September admitted for investigation, detection of bone density. The diabetic patients with abnormal bone mass was 655, type 2 diabetes for the 445 people who have diabetes and abnormal bone mass (osteopenia and osteoporosis) as the case group, the normal bone mass as control group. Including the general situation of patients were collected: age, sex, smoking, blood pressure, body mass index (BMI), and biochemical indexes: fasting blood glucose (FPG), cholesterol (CHOL), triglyceride (TG) , low density lipoprotein (LDL), high density lipoprotein (HDL), calcium (Ca), phosphorus (P), glycosylated hemoglobin (HbA1c), urea nitrogen (BUN), creatinine (Cr), fasting insulin (FINS), index of diabetic microvascular complications. The patients general condition, biochemical index and diabetes related complications were analyzed using spss20.0 statistical software for data analysis, measurement data with normal distribution was used. S said, between the two groups were compared by t test; do not conform to normal distribution and use the median four points spacing of description, comparison between groups by non parametric test; using frequency countdata description, comparison between groups with ~2 test, using non conditional Logistic regression analysis on Influencing Factors of P0.05, with significant difference. Results: 1) diabetic patients with abnormal bone mass group, age less than 49 years old accounted for 31.8% of the number of men, women accounted for 32%; 50~5 The number of men 9 years of age accounted for 68.3%, women accounted for 78.4%; the number of men 60~69 years of age accounted for 50.7%, the number of women accounted for 91.6%; the number of men 70 years of age accounted for 72.5%, accounting for the number of women age 83.2%. in the diabetic group in a 49 year old male accounted for 68.2%, the number of women accounted for 68%, 50~59 years old male accounted for 31.7% the number of women, accounting for 21.6%, 60~69 year old male accounted for 49.3%, the number of women accounted for 8.4%, the number of men in the age of 70 accounted for 27.5%, women accounted for 16.8%; 2) between the two groups in age, duration, BMI, systolic blood pressure, gender, there were statistically significant aspects of smoking and other factors (P0.05), which patients with type 2 diabetes, abnormal bone mass group in age, duration, systolic blood pressure higher than the diabetic group, BMI was lower than that of type 2 diabetes mellitus group (P0.05). Diabetic nephropathy, retinopathy, neuropathy, diabetes and abnormal bone mass was significantly increased, and there was statistical significance (P0.001); 3) Diabetic patients with abnormal bone mass group of FPG, HbA1c higher than the diabetic group, the two groups had statistical significance (P0.01, P0.05), diabetic group FINS, Cr, TG higher than the case group, the two groups had statistical significance (P0.01, P0.05), in male diabetic patients with abnormal bone mass group of FPG, Cr, HbA1c higher than the diabetic group, the two groups have statistical significance (P0.01, P0.05), diabetic group FINS, LDL higher than the case group, the two groups had statistical significance (P0.01, P0.05). In the female diabetic patients with abnormal bone mass group of FPG, HbA1c higher than the diabetic group, the two groups had statistical significance (P0.01); 4) with the increase of the age and course of disease, the incidence rate of abnormal bone mass increased in patients with type 2 diabetes, older than 50 years old, either male or female incidence of abnormal bone mass increased significantly, and higher in women than men, there was significant difference between two groups (P0.05); 5) regression analysis found that the use of logistics Female, age, duration, smoking, high blood glucose, HbA1c and diabetic complications (retinopathy, neuropathy, nephropathy) is a risk factor for diabetes and abnormal bone mass. Conclusion: age, smoking, duration of disease, BMI, blood glucose, glycosylated hemoglobin, diabetes and complications in patients with abnormal sex is a major independent risk of type 2 diabetes mellitus with bone mass factors.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2

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