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2型糖尿病绝经后土耳其女性骨质疏松症的患病率及影响骨密度的因素

Prevalence of osteoporosis and factors affecting bone mineral density among postmenopausal Turkish women with type 2 diabetes.

作者信息

Anaforoglu Inan, Nar-Demirer Asli, Bascil-Tutuncu Neslihan, Ertorer Melek Eda

机构信息

Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

J Diabetes Complications. 2009 Jan-Feb;23(1):12-7. doi: 10.1016/j.jdiacomp.2007.06.004. Epub 2008 Apr 16.

Abstract

OBJECTIVES

Controversy remains as to the effects of type 2 diabetes on bone metabolism. The aims of this study were to assess the association between type 2 diabetes and bone mineral density (BMD) and to evaluate the possible relationship between chronic diabetic complications and bone density.

METHODS

Bone mineral densities at the lumbar spine, femur, and radius in 206 postmenopausal Turkish women with type 2 diabetes were evaluated by dual-energy X-ray absorptiometry and compared with those in 61 age-matched postmenopausal nondiabetic women. Medical and lifestyle characteristics, body mass index (BMI), hemoglobin A1c level, and status of microvascular and macrovascular diabetic complications were recorded. Frequency of osteoporosis and that of osteopenia as well as the relationship between microvascular and macrovascular complications and BMD were evaluated.

RESULTS

The groups did not differ on BMDs and T scores at the hip, lumbar spine, and radius. Patients with radial and/or lumbar and/or hip osteoporosis had a longer duration of diabetes (P=.000), were older (P=.000), and had a lower BMI (P=.000). No correlation was found between osteopenia or osteoporosis and hemoglobin A1c level, presence of microalbuminuria, retinopathy, neuropathy, peripheral artery disease, cerebrovascular event, and coronary artery disease. Among the three sites, BMD at the hip was positively correlated with BMI (P=.000) but negatively correlated with age (P=.000) and duration of diabetes (P=.000). Presence of microalbuminuria revealed a negative correlation with BMD at the femoral neck (P=.042).

CONCLUSION

There is no evidence that type 2 diabetes influenced BMD in our postmenopausal patient group.

摘要

目的

2型糖尿病对骨代谢的影响仍存在争议。本研究的目的是评估2型糖尿病与骨密度(BMD)之间的关联,并评估慢性糖尿病并发症与骨密度之间的可能关系。

方法

采用双能X线吸收法评估206名绝经后土耳其2型糖尿病女性患者腰椎、股骨和桡骨的骨密度,并与61名年龄匹配的绝经后非糖尿病女性患者的骨密度进行比较。记录患者的医疗和生活方式特征、体重指数(BMI)、糖化血红蛋白水平以及微血管和大血管糖尿病并发症的情况。评估骨质疏松症和骨质减少症的发生率以及微血管和大血管并发症与骨密度之间的关系。

结果

两组在髋部、腰椎和桡骨的骨密度及T值方面无差异。患有桡骨和/或腰椎和/或髋部骨质疏松症的患者糖尿病病程更长(P = 0.000)、年龄更大(P = 0.000)且BMI更低(P = 0.000)。未发现骨质减少或骨质疏松与糖化血红蛋白水平、微量白蛋白尿的存在、视网膜病变、神经病变、外周动脉疾病、脑血管事件和冠状动脉疾病之间存在相关性。在三个部位中,髋部骨密度与BMI呈正相关(P = 0.000),但与年龄(P = 0.000)和糖尿病病程(P = 0.000)呈负相关。微量白蛋白尿的存在与股骨颈骨密度呈负相关(P = 0.042)。

结论

没有证据表明2型糖尿病会影响我们绝经后患者组的骨密度。

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