2型糖尿病患者中骨质疏松分布状态及影响因素分析

发布时间：2018-06-12 12:30

  本文选题：2型糖尿病 + 肥胖　； 参考：《吉林大学》2017年硕士论文

【摘要】：目的:了解T2DM患者中的OP分布状态,并对其影响因素进行分析,为早期诊断、早期防治DM并发OP提供临床线索。方法:收集2014年9月~2015年12月于吉林大学第二医院内分泌科住院T2DM患者891例,包含男性479例,女性412例。回顾患者住院期间BMD水平、Hb A1c水平、血脂、血压、空腹血糖、甲状腺功能等指标,根据患者的BMD水平分为骨量正常组(335例)、骨量减少组(399例)以及OP组(157例),对比分析三组T2DM患者的性别、年龄、体重指数、腰围、病程、烟龄、高血压病史、FPG、FCP、2小时C肽、BMD值、Hb A1c、TG、TC、LDL和甲状腺功能的差异,并进行相关性分析。结果:1)在性别方面,T2DM患者中OP组女性比例明显高于男性,P0.0001。2)在BMI水平方面,BMI≥28(kg/m2)的T2DM患者中,OP的比率显著降低,P0.0001。3)在腰围水平方面,男性≥90cm以及女性≥85cm的T2DM患者中,OP的比例降低,P=0.0002。4)在高龄、低腰围水平、低BMD水平、低TG水平的T2DM患者中,其OP的比例均显著增高,均为P0.0001;患有高血压、高LDL水平的T2DM患者中,其OP所占比重较高,分别为P=0.0121,P=0.0465;OP组中,Hb A1c值较高,然而差别不具有统计学的意义P=0.7237;而烟龄、病程、甲功、血清C肽水平在三种骨量分组中的差别均无统计学的意义。5)通过研究潜在危险因素和不同骨量分组的相关性得出,在T2DM中,年龄、LDL水平和OP呈正相关性;腰围、空腹血糖、TG值以及股骨颈、腰椎1-4、髋部的BMD值与OP呈负相关性。结论:1)2型糖尿病者中年龄、性别、腰围、血压、血糖、血脂、BMI水平、BMD水平和骨质疏松发生密切相关。2)腹型肥胖和高BMI水平为OP的保护因子。3)2型糖尿病人群中,女性、高龄、低体质量病人中骨质疏松的发生风险增加,这些患者应注意定期筛查骨密度水平,同时针对骨质疏松做出早期预防。4)T2DM病人中,高血压、血脂代谢紊乱、血糖控制不佳均会引起OP的产生风险增高,所以控制血糖稳定的同时也要保持血压、血脂水平的正常。
[Abstract]:Objective: to investigate the distribution of op in patients with T2DM and analyze its influencing factors so as to provide clinical clues for early diagnosis and early prevention and treatment of DM complicated with op. Methods: from September 2014 to December 2015, 891 T2DM patients, including 479 males and 412 females, were enrolled in the Department of Endocrinology, second Hospital of Jilin University. The levels of BMD and HbA1c, blood lipids, blood pressure, fasting blood glucose, thyroid function and so on were reviewed. According to the BMD level of the patients, they were divided into normal bone mass group (335 cases) and bone mass reduction group (399 cases) and op group (157 cases). Sex, age, body mass index, waist circumference, course of disease, smoking age of three groups of T2DM patients were compared and analyzed. The BMD value of 2-hour C peptide in FPGG / FCPT was compared with the difference between HbA1cTGN TCU LDL and thyroid function, and the correlation analysis was carried out. Results the proportion of females in op group was significantly higher than that in males (P0.0001.2). The ratio of op in T2DM patients with BMI 鈮，

本文编号：2009677