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老年男性2型糖尿病患者骨质疏松症与颈动脉硬化的相关性研究 被引量:5

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摘要 目的 探讨老年男性2型糖尿病患者骨质疏松症与颈动脉硬化的相关性.方法 随机选取老年男性2型糖尿病患者120例.其中骨质疏松症组60例,非骨质疏松症组60例.比较两组基线资料(年龄、糖尿病病程、体重指数).采集清晨空腹静脉血,测定患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(AKP)、肌酐(Cr)、尿酸(UA)、甘油三酯(TG)等生化指标 25-羟维生素D(25(0H)D)、PTH等骨代谢指标 糖化血红蛋白(HbAlc)、空腹血糖(FBG)、胰岛素(Fins)、C肽(FCP)等糖代谢指标.采集清晨尿液标本,测定尿微量白蛋白/尿肌酐比(ACR)、24h尿蛋白定量.比较两组各项临床数据差异.进行颈动脉彩超检查,判定是否存在颈动脉粥样硬化,比较两组颈动脉粥样硬化的患病率.结果 (1)骨质疏松组较非骨质疏松组年龄大、体重指数低,差异有统计学意义(P<0.05).(2)骨质疏松组与非骨质疏松组两组临床资料对比后发现其中HbAlc,骨质疏松组较非骨质疏松组高,差异有统计学意义(P<0.05).尿酸、25-羟维生素D、甘油三酯,骨松组较非骨松组显著降低,差异有统计学意义(P<0.05).(3)颈动脉硬化组比无硬化组,各部位骨密度均低,其中以股骨颈部位骨密度差异有统计学意义(P<0.05).(4)以骨质疏松症诊断是否成立为因变量经二元Logistic回归分析,25羟-维生素D(b=-0.044,P=0.059)、BMI(b=-0.162,P=0.012)、颈动脉粥样斑块(b=1.020,P=0.029).结论 (1)高龄、消瘦的老年男性2型糖尿病患者,更容易患骨质疏松症.(2)高甘油三酯血症可能降低糖尿病合并骨质疏松症风险.(3)颈动脉粥样硬化可能为老年男性2型糖尿病患者合并骨质疏松者的独立危险因素. Objective To study the relationship between osteoporosis and carotid atherosclerosis in elderly male patient with type 2 diabetes. Methods The medical records of 120 elderly male patients with type 2 diabetes were retrospectively analyzed. Baseline data(age,duration of diabetes and body mass index)were compared between the two groups. The patients were divided into osteoporosis group,non-osteoporosis group according to the T value. Fasting venous blood was collected. Determination of creatinine(Cr),uric acid(UA)and homocysteine(Hcy),triglycerides(TG), and other biochemical indicators were measured. Vitamin D and 25 25(0h)(D),glycosylated hemoglobin(HbAlc)and the fasting blood glucose (FBG),insulin(Fins)c-peptide(FCP)were collected. The difference of the clinical indicators and prevalence of diabetic microangiopathy between the two groups was compared. High resolution c010r Doppler ultrasound was used to detect the carotid artery medial plaque. Results (1) The two groups of clinical data showed that the HbAlc,age were higher in osteoporosis group than that of non-osteoporosis group,P<0.05. Uric acid,25 - hydroxyl vitamin D,TG value,BMD were lower in osteoporosis group than that of non-osteoporosis,P<0.05.(2)In osteoporosis group (60 cases),there were 49 cases with atherosclerotic plaque(87.67%). Compared with non-osteoporosis group,30 cases atherosclerotic plaque (65%)increased significantly in osteoporosis group(P<0.05).(3)After logistic regression adjustment,it was observed that 25 hydroxy - vitamin D (b=-0.044,P=0.059),body mass index(b=-0.162,P=0.012),plaque formation(b=1.020,P=0.029)were independent impact factors for osteoporosis patients who were with type 2 diabetes. Conclusion There is a close relationship between osteoporosis and atherosclerosis in the elderly. Atherosclerosis is more likely to occur in patients with osteoporosis than in non-osteoporosis.
出处 《浙江临床医学》 2018年第11期1848-1850,共3页 Zhejiang Clinical Medical Journal
关键词 2型糖尿病 骨质疏松 骨密度 颈动脉粥样硬化 Type 2 diabetes mellitus Osteoporosis Bone density Carotid atherosclerosis
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