| 2型糖尿病患者动脉粥样硬化与骨密度及骨折风险的关系研究 |
| 投稿时间：2025-03-25 修订日期：2025-05-06 点此下载全文 |
| 引用本文：付沛旗,任秋月,韩景辉.2型糖尿病患者动脉粥样硬化与骨密度及骨折风险的关系研究[J].医学研究杂志,2025,54(9):86-90, 4 |
| DOI：
10.11969/j.issn.1673-548X.2025.09.015 |
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| 基金项目:国家自然科学基金青年科学基金资助项目(82305019)；河南省科技攻关项目(242102311252) |
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| 中文摘要:目的 探讨2型糖尿病(type 2diabetes mellitus, T2DM)患者动脉粥样硬化(atherosclerosis, AS)与骨密度(bone mineral density, BMD)及骨折风险的关系。方法 纳入380例50～80岁T2DM患者,根据颈动脉内中膜厚度分为合并AS组与不合并AS组,比较两组临床指标,分析AS与BMD及骨折风险的关系。结果 合并AS组年龄、糖尿病病程、骨质减少发生率、10年内重要部位骨折风险(the 10-year probability of a major osteoporotic fracture, PMOF)、10年内髋部骨折风险(the 10-year probability of hip fracture, PHF)均高于不合并AS组,而股骨颈BMD更低。男性T2DM患者的PMOF、PHF与年龄、糖尿病病程及AS病变呈正相关,与总胆固醇、甘油三酯、低密度脂蛋白、25-羟基维生素D、Ⅰ型前胶原氨基端肽及BMD呈负相关；女性T2DM患者的PMOF、PHF与停经时长、空腹胰岛素及AS病变呈正相关,与血磷、BMD呈负相关。回归分析结果显示,男性T2DM患者中骨质减少为AS病变的独立危险因素,AS病变为BMD水平的独立危险因素,体重指数为BMD水平的独立保护因素；女性T2DM患者中年龄、FINS、高密度脂蛋白为BMD水平的独立危险因素,甲状旁腺激素为BMD水平的独立保护因素。结论 T2DM患者合并AS病变时,低骨量和骨质疏松的发生率更高,出现股骨颈BMD水平下降及PMOF、PHF升高。男性研究对象中,低骨量和骨质疏松是AS病变的独立危险因素,AS病变是BMD水平的独立危险因素。 |
| 中文关键词:2型糖尿病 动脉粥样硬化 骨密度 骨折风险 |
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| Association between Atherosclerosis in Type 2 Diabetes Mellitus and Bone Mineral Density and Fracture Risk |
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| Abstract:Objective To explore the relationship between atherosclerosis (AS) and bone mineral density (BMD) as well as fracture risk in patients with type 2diabetes mellitus (T2DM). Methods A total of 380 T2DM patients aged 50-80 years were included and divided into AS group and non-AS group based on carotid intima-media thickness. Clinical indicators were compared between the two groups, and the relationship between AS and BMD as well as fracture risk was analyzed. Results The AS group had higher age, diabetes duration, incidence of osteopenia, 10-year probability of major osteoporotic fracture (PMOF), and 10-year probability of hip fracture (PHF), while having lower femoral neck BMD than the non-AS group. In male T2DM patients, PMOF and PHF were positively correlated with age, diabetes duration, and AS lesions, and negatively correlated with total cholesterol, triglycerides, low-density lipoprotein, 25-hydroxyvitamin D, type Ⅰ procollagen amino-terminal peptide, and BMD. In female T2DM patients, PMOF and PHF were positively correlated with menopause duration, fasting insulin, and AS lesions, and negatively correlated with blood phosphorus and BMD. Regression analysis showed that osteopenia was an independent risk factor for AS lesions in male T2DM patients, AS lesions were an independent risk factor for BMD levels, and body mass index was an independent protective factor for BMD levels. In female T2DM patients, age, fasting insulin, and high-density lipoprotein were independent risk factors for BMD levels, and parathyroid hormone was an independent protective factor for BMD levels. Conclusion When T2DM patients have AS lesions, the incidence of low bone mass and osteoporosis is higher, with decreased femoral neck BMD and increased PMOF and PHF. In male subjects, low bone mass and osteoporosis are independent risk factors for AS lesions, and AS lesions are also independent risk factors for BMD levels. |
| keywords:Type 2diabetes Atherosclerosis Bone mineral density Risk of fracture |
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