摘要
目的探究女性2型糖尿病(T2DM)患者血清钙、磷、25羟维生素D[25-(OH)D]、碱性磷酸酶(ALP)、甲状旁腺素(PTH)水平变化,并分析其与骨质疏松症发生的相关性。方法选取2022年1~12月驻马店中心医院收治的86例T2DM合并骨质疏松症患者(合并骨质疏松症组)和53例T2DM患者(T2DM组)进行回顾性研究,所有患者均为女性。比较两组患者的血清钙、磷、25-(OH)D、ALP和PTH水平,绘制受试者工作特征(ROC)曲线分析各指标对患者合并骨质疏松症的诊断价值;采用多元Logistic回归分析各指标是否为T2DM患者并发骨质疏松症的危险因素;根据患者骨质疏松症严重程度将合并骨质疏松症组患者分为轻度组59例和重度组27例,比较两组患者的血清指标及骨密度T值,并采用Pearson相关性检验分析两者间的相关性。结果合并骨质疏松症组患者的血清钙、25-(OH)D水平分别为(2.28±0.16)mmol/L、(15.82±3.25)ng/mL,明显低于T2DM组的(2.36±0.21)mmol/L、(20.34±3.07)ng/m L,ALP、PTH水平分别为(55.16±5.49)U/L、(50.06±9.64)ng/L,明显高于T2DM组的(51.03±5.25)U/L、(42.37±8.29)ng/L,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,以上各项指标联合检测诊断女性T2DM患者并发骨质疏松症的AUC值大于各指标单独检测,差异均有统计学意义(P<0.05);合并骨质疏松症组中ALP≥52.28 U/L、PTH≥43.50 ng/L的人数比例分别为82.56%、75.58%,明显高于T2DM组的52.83%、49.06%,钙≥2.29 mmol/L、磷≥1.19 mmol/L、25-(OH)D≥17.95 ng/mL的人数比例分别为40.70%、61.63%、22.09%,明显低于T2DM组的62.26%、83.02%、84.91%,差异均有统计学意义(P<0.05);多元Logistic回归分析结果显示,ALP≥52.28 U/L、PTH≥43.50 ng/L均是女性T2DM患者并发骨质疏松症的危险因素(P<0.05),25-(OH)D≥17.95 ng/mL为保护因素(P<0.05);重度组患者的25-(OH)D水平为(13.27±2.49)ng/mL,明显低于轻度组的(16.99±3.06)ng/mL,ALP、PTH水平分别为(59.13±6.85)U/L、(55.65±6
Objective To explore the changes of serum calcium,phosphorus,25-hydroxyvitamin D[25-(OH)D],alkaline phosphatase(ALP),and parathyroid hormone(PTH)in female patients with type 2 diabetes mellitus(T2DM),and analyze their correlation with occurrence of osteoporosis.Methods Eighty-six patients with T2DM complicated with osteoporosis(osteoporosis group)and 53 patients with T2DM(T2DM group)from January 2022 to December 2022 were selected from Zhumadian Central Hospital for retrospective study.All the enrolled patients were females.The levels of serum calcium,phosphorus,25-(OH)D,ALP,and PTH were compared between the two groups.The diagnostic value of each indicator on patients with osteoporosis was analyzed by drawing receiver operating characteristic(ROC)curve,and multivariate logistic regression analysis was used to analyze whether indicators were risk factors for osteoporosis in patients with T2DM.According to the severity of osteoporosis,the patients with osteoporosis were divided into mild group(59 cases)and severe group(27 cases),and serum indicators and bone mineral density T value were compared between the two groups.The correlation between serum indicators and bone mineral density T value was analyzed by Pearson correlation analysis.Results The levels of serum calcium and 25-(OH)D in osteoporosis group were(2.28±0.16)mmol/L and(15.82±3.25)ng/mL,significantly lower than(2.36±0.21)mmol/L and(20.34±3.07)ng/mL in T2DM group;the levels of ALP and PTH were(55.16±5.49)U/L and(50.06±9.64)ng/L,significantly higher than(51.03±5.25)U/L and(42.37±8.29)ng/L in T2DM group;the differences were statistically significant(P<0.05).ROC curve revealed that the AUC value of combined detection of the above indicators in the diagnosis of osteoporosis in female patients with T2DM was higher than that of detection of each indicator alone(P<0.05).The proportions of patients with ALP≥52.28 U/L and PTH≥43.50 ng/L in osteoporosis group were 82.56%and 75.58%,significantly higher than 52.83%and 49.06%in T2DM group;the proportions o
作者
任晓静
程远
李园园
王连伟
REN Xiao-jing;CHENG Yuan;LI Yuan-yuan;WANG Lian-wei(Department of Endocrinology,Zhumadian Central Hospital,Zhumadian 463000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第19期2812-2816,共5页
Hainan Medical Journal
基金
河南省医学科技攻关计划省部共建项目(编号:SBGJ2023062)。
关键词
女性
2型糖尿病
钙
磷
25羟维生素D
碱性磷酸酶
甲状旁腺素
骨质疏松症
相关性
Female
Type 2 diabetes mellitus
Calcium
Phosphorus
25-hydroxyvitamin D
Alkaline phosphatase
Parathyroid hormones
Osteoporosis
Correlation
