2型糖尿病合并骨质疏松症与脂代谢异常的相关性分析

发布时间：2018-05-03 03:23

本文选题：2型糖尿病 + 骨质疏松症　；参考：《华北理工大学》2015年硕士论文

【摘要】：目的探讨2型糖尿病(T2DM)患者脂代谢紊乱与骨质疏松的关系,为糖尿病合并骨质疏松的防治提供相关理论依据。方法选取华北理工大学附属医院内分泌科住院的2型糖尿病患者185例,男性91例,女性94例,年龄范围37~70岁,平均年龄56.10±7.10岁。根据骨密度测定结果分为骨质疏松症组71例,其中男性22例,女性49例,年龄波动在37~70岁,平均58.13±6.66岁,无骨质疏松症组114例,其中男性69例,女性45例,年龄波动在37~70岁,平均54.84±7.11岁。入组患者均测定腰椎前后位总体(L1-4)面积BMD,比较两组性别、年龄、体重指数(BMI),收缩压、舒张压,空腹血糖(FPG)、餐后2小时血糖(2h PG)、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、超敏C反应蛋白(hs-CRP)等指标,所有数据分析应用IBM SPSS19.0统计软件包进行统计分析,正态分布计量资料以均数±标准差(x±s)表示,组间均数比较采用独立样本t检验;计数资料采用百分率表示,组间率的比较采用卡方检验;2型糖尿病合并骨质疏松的危险因素采用多因素非条件Logistic回归分析,各指标对骨密度的影响采用多元线性回归分析。结果两组间经卡方检验显示骨质疏松症组女性较无骨质疏松症组所占比例高(P=0.0000.05),骨质疏松症组与无骨质疏松症组年龄比较,骨质疏松症组高于无骨质疏松症组,差异有统计学意义(P=0.0140.05)。骨质疏松症组与无骨质疏松症组收缩压、舒张压、FPG、2h PG、hs-CRP比较差异无统计学意义(P0.05)。骨质疏松症组与无骨质疏松症组BMI比较,骨质疏松症组低于无骨质疏松症组差异有统计学意义(P=0.0090.05)。骨质疏松症组与无骨质疏松症组TC、LDL-C比较,骨质疏松症组高于无骨质疏松症组,差异有统计学意义(P=0.0410.05、P=0.0000.05)。两组间TG、HDL-C比较差异无统计学意义(P0.05)。经卡方检验显示骨质疏松症组LDL-C3.61mmol/L所占比例高于无骨质疏松症组,差异有统计学意义(P0.05)。以是否合并骨质疏松为因变量,以性别、年龄、体重指数、TC、TG、HDL-C、LDL-C为自变量进行多因素非条件Logistic回归分析,LDL-C、性别、年龄为2型糖尿病患者合并骨质疏松的独立相关因素(P0.05),体重指数为T2DM患者骨密度的保护因素。多元线性回归分析显示,LDL-C、性别、年龄与T2DM患者骨密度呈负相关,而BMI与T2DM患者骨密度呈正相关。结论高LDL-C水平是T2DM患者合并骨质疏松症的独立相关因素。
[Abstract]:Objective to investigate the relationship between lipid metabolism disorder and osteoporosis in patients with type 2 diabetes mellitus (T2DM), and to provide theoretical basis for the prevention and treatment of diabetes mellitus complicated with osteoporosis. Methods 185 patients with type 2 diabetes mellitus (91 males and 94 females), aged 3770 years, with an average age of 56.10 卤7.10 years, were selected from the Endocrinology Department of affiliated Hospital of North China University of Technology. According to the results of bone mineral density measurement, 71 cases of osteoporosis were divided into male 22 cases, female 49 cases, the age fluctuating from 37 to 70 years old, mean 58.13 卤6.66 years old, 114 cases of no osteoporosis group, male 69 cases, female 45 cases, the age fluctuation was 3770 years old. Mean 54.84 卤7.11 years old. The total area of L1-4) in the anterior and posterior lumbar vertebrae was measured. Sex, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) were compared between the two groups. Fasting blood glucose (FPG), 2 hours postprandial glucose and 2 h PGN, serum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), hypersensitive C-reactive protein (hs-CRP), and so on. All the data were analyzed by IBM SPSS19.0 statistical software package. The measurement data of normal distribution are expressed as mean 卤standard deviation (x 卤s), the comparison of mean among groups is expressed by independent sample t test, and the counting data is expressed as percentage. The risk factors of type 2 diabetes mellitus complicated with osteoporosis were analyzed by multivariate Logistic regression analysis and multiple linear regression analysis were used to analyze the effect of each index on bone mineral density (BMD). Results the chi-square test between the two groups showed that the proportion of female in osteoporosis group was higher than that in no osteoporosis group. The age of osteoporosis group was higher than that of no osteoporosis group, and the age of osteoporosis group was higher than that of no osteoporosis group. The difference was statistically significant (P = 0.0140.05). There was no significant difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between osteoporosis group and osteoporosis group (P 0.05). The BMI of osteoporosis group was significantly lower than that of no osteoporosis group (P 0.0090.05). Compared with those without osteoporosis, the LDL-C of osteoporosis group was higher than that of no osteoporosis group, and the difference was statistically significant (P < 0.05). There was no significant difference in HDL-C between the two groups (P 0.05). Chi-square test showed that the proportion of LDL-C3.61mmol/L in osteoporosis group was higher than that in no osteoporosis group, the difference was statistically significant (P 0.05). Using sex, age and body mass index (BMI) as independent variables, multivariate Logistic regression analysis was carried out to determine the sex. The age of type 2 diabetic patients with osteoporosis was independent of P0. 05 and BMI was the protective factor of bone mineral density in patients with T2DM. Multiple linear regression analysis showed that LDL-C, sex and age were negatively correlated with bone mineral density (BMD) in T2DM patients, while BMI was positively correlated with BMD in T2DM patients. Conclusion High LDL-C level is an independent risk factor for osteoporosis in T2DM patients.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R580

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