老年2型糖尿病代谢综合征患者骨质疏松危险因素研究

doi:10.3969/j.issn.1006-7795.2020.01.021

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (1): 108-112.doi: 10.3969/j.issn.1006-7795.2020.01.021

老年2型糖尿病代谢综合征患者骨质疏松危险因素研究

修双玲^1,2, 穆志静¹, 孙丽娜¹, 赵蕾¹, 韩青¹, 曹雪霞¹

1. 首都医科大学宣武医院内分泌科, 北京 100053;
2. 首都医科大学老年医学系, 北京 100069

收稿日期:2019-06-03 出版日期:2020-02-21 发布日期:2020-02-13
通讯作者: 修双玲 E-mail:xiushuangling@126.com
基金资助:
北京市属医院科研培育项目（2020034）。

Risk factors for osteoporosis in patients with metabolic syndrome in old people with type 2 diabetes mellitus

Xiu Shuangling^1,2, Mu Zhijing¹, Sun Lina¹, Zhao Lei¹, Han Qing¹, Cao Xuexia¹

1. Department of Endocrinology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Geriatrics, Capital Medical University, Beijing 100069, China

Received:2019-06-03 Online:2020-02-21 Published:2020-02-13
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals Incubating Program (2020034).

摘要/Abstract

摘要： 目的探索老年2型糖尿病（type 2 diabetes mellitus，T2DM）代谢综合征患者骨质疏松的危险因素。方法纳入首都医科大学宣武医院内分泌科≥60岁的2型糖尿病代谢综合征患者301例，测定糖化血红蛋白（hemoglobin A1c，HbA1c）、空腹胰岛素（fasting insulin，FINS），维生素D、血脂、C反应蛋白（C-reactive protein，CRP）、白细胞介素-6（interleukin-6，IL-6），计算体质量指数（body mass index，BMI）。并进行骨密度（bone mineral density，BMD）、四肢骨骼肌肌肉质量（appendicular skeletal muscle mass，ASM）及握力测定，分析骨质疏松的危险因素。结果老年2型糖尿病代谢综合征患者骨质疏松组BMI、维生素D、骨骼肌肌肉质量指数（appendicular skeletal muscle mass index，ASMI），握力显著低于骨质疏松组（P < 0.05）。多元Logistic回归分析显示，女性、低握力显著增加骨质疏松的风险（分别为OR=2.85，P<0.001； OR=2.34，P=0.034），高BMI显著降低骨质疏松风险（OR=0.84，P<0.001）。结论女性、低握力是老年2型糖尿病代谢综合征患者骨质疏松独立的危险因素，BMI为其保护因素。

关键词: 2型糖尿病, 代谢综合征, 握力, 骨密度, 骨质疏松

Abstract: Objective To explore the risk factors for osteoporosis in patients with metabolic syndrome in old people with type 2 diabetes mellitus. Methods A total of 301 old people with metabolic syndrome and type 2 diabetes aged more than 60 years-old were included in the study. Levels of hemoglobin A1c(HbA1c), fasting insulin (FINS), vitamin D, blood lipid, serum C-reactive protein (CRP)and interleukin-6 (IL-6) were measured. Body mass index (BMI) was calculated. Furthermore, bone mineral density (BMD), skeletal muscle mass and grip strength were assessed. The risk factors for osteoporosis were evaluated. Results Compared with people without osteoporosis, people with osteoporosis had lower levels of BMI, vitamin D, skeletal muscle mass index and grip strength (P < 0.05). In a multiple stepwise Logistic analysis, being female and lower grip strength were associated increased risk of osteoporosis (OR=2.85, P < 0.001; OR=2.34, P < 0.001, respectively), while higher BMI was associated with decreased risk of osteoporosis (OR=0.84, P < 0.001).Conclusion Being female and lower grip strength were independent risk factors for osteoporosis in patients with metabolic syndrome in old people with type 2 diabetes mellitus, while higher BMI was a protective factor.

Key words: type 2 diabetes mellitus, metabolic syndrome, handgrip strength, bone mineral density, osteoporosis

中图分类号:

R587.l

修双玲, 穆志静, 孙丽娜, 赵蕾, 韩青, 曹雪霞. 老年2型糖尿病代谢综合征患者骨质疏松危险因素研究[J]. 首都医科大学学报, 2020, 41(1): 108-112.

Xiu Shuangling, Mu Zhijing, Sun Lina, Zhao Lei, Han Qing, Cao Xuexia. Risk factors for osteoporosis in patients with metabolic syndrome in old people with type 2 diabetes mellitus[J]. Journal of Capital Medical University, 2020, 41(1): 108-112.

参考文献

[1] Wang D,Liu N,Gao Y,et al. Association between metabolic syndrome and osteoporotic fracture in middle-aged and elderly Chinese peoples[J]. Cell Biochem Biophys,2014,70(2):1297-1303.
[2] Chen D Z,Xu Q M,Wu X X,et al. The combined effect of nonalcoholic fatty liver disease and metabolic syndrome on osteoporosis in postmenopausal females in Eastern China[J]. Int J Endocrinol,2018, 2018:2314769.
[3] Sok W,Kok-Yong C,Farihah S,et al. The relationship between metabolic syndrome and osteoporosis:a review[J]. Nutrients,2016,8(6):347.
[4] World Health Organization.Definition, diagnosis and classification of diabetes mellitus and its complications:Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus[M]. Geneva:World Health Organization, 1999.
[5] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013版)[J].中华糖尿病杂志,2014,6(7):437-448.
[6] Baumgartner R N. Body composition in healthy aging[J]. Ann N Y Acad Sci,2000,904(1):437-448.
[7] Kanis J A, Melton L J, Christiansen C, et al. The diagnosis of osteoporosis[J]. J Bone Miner Res,1994,9(8):1137-1141.
[8] Chen L K,Liu L K,Woo J,et al. Sarcopenia in Asia:consensus report of the Asian working group for sarcopenia[J]. J Am Med Dir Assoc,2014,15(2):95-101.
[9] 中华医学会骨质疏松与骨矿盐疾病分会.肌少症共识[J].中华骨质疏松和骨矿盐疾病杂志,2016,9(9):215-227.
[10] Norman K,Stobaus N,Gonzalez M C,et al. Hand grip strength:outcome predictor and marker of nutritional status[J]. Clin Nutr,2011,30(2):135-142.
[11] Hasegawa Y,Schneider P,Reiners C. Age,sex,and grip strength determine architectural bone parameters assessed by peripheral quantitative computed tomography (pQCT) at the human radius[J]. J Biomeeh,2001,34(4):497-503.
[12] Dixon W G,Lunt M,Pye S R,et al. Low grip strength is associated with bone mineral density and vertebral fracture in women[J]. Rheumatology (Oxford),2005,44(5):642-646.
[13] Sirola J,Tuppurainen M,Honkanen R,et al. Associations between grip strength change and axial postmenopausal bone loss-a 10-year population-based follow up study[J]. Osteoporos Int,2005,16(12):1841-1848.
[14] Kim S,Won C W,Kim B S,et al. The association between the low muscle mass and osteoporosis in elderly Korean people[J]. J Korean Med Sci,2014,29(7):995-1000.
[15] Cao J J. Effects of obesity on bone metabolism[J]. J Orthop Surg Res,2011,6(1):30.
[16] 雷映红,陈辉,刘菊.老年2型糖尿病患者骨密度与炎性反应因子相关性研究[J].中国骨质疏松杂志,2017,23(2):213-215.
[17] 吴小宝,陈薇,周超.肌肉强度和肌肉质量与绝经后女性骨密度的相关性研究[J].中国骨质疏松杂志,2019,25(7):942-946.
[18] 修双玲,孙丽娜,曹雪霞,等.老年男性2型糖尿病患者尿酸与骨质疏松的相关性[J].中华骨质疏松和骨矿盐疾病杂志,2019,12(2):115-119.

老年2型糖尿病代谢综合征患者骨质疏松危险因素研究

Risk factors for osteoporosis in patients with metabolic syndrome in old people with type 2 diabetes mellitus

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