摘要
目的探讨老年2型糖尿病(T2DM)患者甲状腺激素、血糖水平的变化与骨密度、微血管病变的相关性。方法选取2017年6月-2019年6月四川省某医院收治的86例老年T2DM患者为研究对象,依据WHO骨质疏松诊断标准将患者分为骨量正常组(n=34)、骨量减少组(n=32)和骨质疏松组(n=20),依据患者是否存在糖尿病神经病变或糖尿病肾病或糖尿病视网膜病变分为微血管病变组(n=23)和无微血管病变组(n=63)。比较骨量正常组、骨量减少组、骨质疏松组患者甲状腺激素[血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)]水平,同时比较微血管病变组和无微血管病变组患者甲状腺激素水平,并分析老年T2DM患者甲状腺激素水平与骨密度、微血管病变的相关性。结果骨量正常组、骨量减少组、骨质疏松组患者TSH、空腹血糖(FBG)及糖化血红蛋白(HbA1c)水平比较,差异有统计学意义(P<0.05);骨质疏松组患者血清TSH、FBG及HbA1c水平高于骨量减少组、骨量正常组,骨量减少组患者TSH、FBG及HbA1c水平高于骨量正常组,差异均有统计学意义(P<0.01)。微血管病变组患者TSH、FBG及HbA1c水平高于无微血管病变组,股骨颈及正位腰椎(L1-4)T值低于无微血管病变组,差异均有统计学意义(P<0.05)。T2DM患者TSH水平与骨密度呈明显负相关,与微血管病变呈明显正相关(P<0.05),而FBG及HbA1c水平与患者骨密度、微血管病变呈明显正相关(P<0.05)。结论老年T2DM患者TSH、FBG、HbA1c水平与骨密度、微血管病变密切相关,而积极监测T2DM患者TSH、FBG及HbA1c水平的变化或可为骨密度异常和微血管病变的预测提供参考。
Objective To investigate the changes in thyroid hormone and glucose levels and their correlation with bone density and microangiopathy in elderly patients with type 2 diabetes mellitus(T2DM).Methods Eighty-six elderly T2DM patients admitted to a hospital in Sichuan from June 2017 to June 2019 were selected and divided into normal bone mass(n=34),reduced bone mass(n=32)and osteoporosis(n=20)groups according to the WHO osteoporosis diagnostic criteria;based on whether the patients had diabetic neuropathy,diabetic nephropathy or diabetic retinopathy,they were divided into microangiopathy(n=23)and microangiopathy-free(n=63)groups as well.The levels of thyroid hormones[thyroid-stimulating hormone(TSH)in serum,free triiodothyronine(FT3),and free thyroxine(FT4)]were compared across the normal bone mass group,the reduced bone mass group,and the osteoporosis group,as well as between the microangiopathy group and the microangiopathyfree group.The correlation between microangiopathy and the levels of thyroid hormones and bone density in elderly T2DM patients was also analyzed.Results The differences in TSH,fasting blood glucose(FBG)and hemoglobin A1c(HbA1c)levels of patients in the normal bone mass group,reduced bone mass group and osteoporosis group were statistically significant(P<0.05);the serum TSH,FBG and HbA1c levels of patients in the osteoporosis group were higher than those in the reduced bone mass group and normal bone mass group,and the TSH,FBG and HbA1c levels of patients in the reduced bone mass group were higher than those in the normal bone mass group,and the differences were all statistically significant(P<0.01).The levels of TSH,FBG and HbA1c were higher in the microangiopathy group than in the microangiopathy-free group,and the femoral neck and orthotopic lumbar(L1-4)T values were lower than those in the microangiopathy-free group,and the differences were all statistically significant(P<0.05).TSH levels in patients with T2DM were significantly and nega-tively correlated with bone density while significantl
作者
付彩雯
吴艳
刘阳
秦娟
李钰艳
黄秀丽
Fu Caiwen;Wu Yan;Liu Yang;Qin Juan;Li Yuyan;Huang Xiuli(Department of Endocrine Metabolic Diseases,Suining Central Hospital,Suining Sichuan 629000,China)
出处
《保健医学研究与实践》
2020年第5期50-54,共5页
Health Medicine Research and Practice
基金
四川省卫生和计划生育委员会科研课题(普及应用项目)(16PJ521)。
关键词
2型糖尿病
老年患者
甲状腺激素
骨密度
微血管病变
相关性
Type 2 Diabetes Mellitus
Elderly Patients
Thyroid Hormone
Bone Density
Microangiopathy
Correlation
