血清胰岛素样生长因子-1水平与2型糖尿病骨密度的关系

发布时间：2018-09-09 18:38

【摘要】：目的观察2型糖尿病合并骨密度减低患者与非骨密度减低患者的血清IGF-1水平,进而探讨其与2型糖尿病合并骨密度减低的相关性,为糖尿病合并骨密度减低的防治提供理论依据。方法依据1999年WHO糖尿病诊断及分型标准共收集华北理工大学附属医院内分泌科住院治疗的214例2型糖尿病患者作为研究对象。根据T2DM患者骨密度水平,选取骨密度减低者86例、骨质疏松症者62例为病例组,骨密度正常者66例为对照组。入组患者均测定骨密度水平,比较三组患者性别、年龄、糖尿病病程、BMI、胰岛素样生长因子-1(IGF-1)、糖化血红蛋白(Hb A1c)、空腹血糖(FPG)、空腹C肽(C-P)、胰岛素抵抗指数(HOMA-IRP)、碱性磷酸酶(ALP)、血钙(Ca)、血磷(P)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖尿病合并症等指标。所有数据分析应用SPSS21.0统计软件分析,正态分布计量资料以均数±标准差(x±s)表示,两组间比较采用独立样本t检验,多组间比较采用单因素方差分析;计数资料采用c2检验;指标间的相关性采用Pearson相关分析,并得出相关系数;多因素之间相关统计采用多因素非条件logisitc回归分析、线性相关分析。检验水准:P0.05为有统计学意义。。结果1三组T2MD患者性别构成通过c2检验结果显示差异有统计学意义(P0.05)。2三组T2MD患者年龄构成经单因素方差分析结果表明差异有统计学意义(P0.05)。3三组T2MD患者IGF-1水平经单因素方差分析显示,差异具有统计学意义(P0.05)。以患者血清IGF-1225ug/L为暴露,IGF-1≥225ug/L为非暴露,结果显示暴露者发生骨密度减低的危险性是非暴露者的4倍,而发生骨质疏松的危险性是非暴露者的19倍,经χ2检验差异有统计学意义(P0.05)。三组间IGF-1水平与性别、年龄、BMI、糖尿病病程、FPG、C-P、Hb Alc、TC、TG、HDL-C、LDL-C、ALP、血Ca、血P、UA的关系经Pearson相关分析结果显示,血清IGF-1水平与病程、TG呈正相关(P0.05),血清IGF-1水平与年龄、FPG、Hb A1c呈负相关(P0.05),IGF-1与性别、BMI、C-P、TC、HDL-C、LDL-C、血Ca、血P、UA无关。4三组T2MD患者BMI、Hb Alc、FPG、C-P、TC的组间差异有统计学意义(P0.005),三组T2MD患者HOMA-IRP、ALP、血Ca、血P、TG、HDL-C、LDL-C、UA的组间差异无统计学意义(P0.05)。5三组T2MD患者是否合并高血压病、冠心病、脑梗死、DPN、PVD,经c2检验显示有统计学意义(P0.005)。6以上述单因素分析中具有统计学意义的因素为自变量,进行多因素非条件二分类logistic回归分析后结果显示血清IGF-1水平与糖尿病患者骨密度减低的关系仍具有统计学意义,进一步证实了血清IGF-1水平与糖尿病患者骨密度减低,当IGF-1水平降低,T2DM患者骨密度减低的危险性增高。结论1随着2型糖尿病患者骨密度水平减低,血清IGF-1水平逐渐减低。2低血清IGF-1水平为T2DM患者骨密度减低的危险因素。
[Abstract]:Objective to observe the serum IGF-1 levels in patients with type 2 diabetes mellitus complicated with reduced bone mineral density (BMD) and to explore the correlation between the level of serum IGF-1 and type 2 diabetes mellitus (T2DM) complicated with decreased bone mineral density (BMD). To provide a theoretical basis for the prevention and treatment of diabetes mellitus complicated with reduced bone mineral density. Methods according to the diagnosis and classification criteria of WHO diabetes in 1999, 214 cases of type 2 diabetes were collected and treated in the Department of Endocrinology, affiliated Hospital of North China University of Science and Technology. According to the level of bone mineral density in T2DM patients, 86 cases of bone mineral density decrease, 62 cases of osteoporosis as case group, 66 cases of normal bone mineral density as control group. The bone mineral density (BMD) was measured in all the patients, and the sex and age of the three groups were compared. BMI, IGF-1, Hb A1c, (FPG), fasting C-peptide (C-P), insulin resistance index (HOMA-IRP), (ALP), (ALP), (Ca), (P), (P), (TC), triglyceride, (TG), high density lipoprotein (HDL-C), fasting blood glucose (FBG), fasting C-peptide (C-P), insulin resistance index (HOMA-IRP). Steroids (HDL-C), low density lipoprotein cholesterol (LDL-C), diabetes mellitus and other indicators. All the data were analyzed by SPSS21.0 statistical software, the normal distribution data were expressed as mean 卤standard deviation (x 卤s), the two groups were compared by independent sample t test, the multigroup comparison by single factor analysis of variance, the count data by c2 test. Pearson correlation analysis was used to analyze the correlation among indicators and the correlation coefficient was obtained. The multivariate unconditioned logisitc regression analysis and linear correlation analysis were used to analyze the correlation among multiple factors. The test level of 0. 05 is statistically significant. Results 1 the sex composition of three groups of T2MD patients showed significant difference by c2 test (P0.05). 2 the age composition of three groups of T2MD patients was significantly different by univariate analysis of variance (P0.05). 3 the IGF-1 level of three groups of T2MD patients was significantly higher than that of the control group (P0.05). Factor variance analysis showed that The difference was statistically significant (P0.05). Taking serum IGF-1225ug/L as exposure and IGF-1 鈮，

本文编号：2233235