Shan Peng-Fei, Wu Xian-Ping, Zhang Hong, Cao Xing-Zhi, Gu Wei, Deng Xiao-Ge, Gu Chi, Liao Er-Yuan
Department of Endocrinology and Metabolism, The Second Affiliated Hospital, ZheJiang University College of Medicine, 310009 Hangzhou, Zhejiang, People's Republic of China.
J Bone Miner Metab. 2009;27(2):190-7. doi: 10.1007/s00774-008-0023-9. Epub 2009 Jan 24.
Bone mineral density (BMD) and its association with body mass index (BMI) are uncertain in postmenopausal women with type 2 diabetes mellitus (T2DM) in mainland China. This study was performed to assess this association including 1,042 postmenopausal women with T2DM and 919 non-diabetic control subjects. Bone mineral density of the posteroanterior spine and of the left hip was measured by use of dual-energy X-ray absorptiometry. Diabetic participants were divided into three groups according to BMI, i.e. low BMI (DML < 18.5 kg/m(2)), intermediate BMI (DMM 18.5-24.9 kg/m(2)), and high BMI (DMH >or= 25 kg/m(2)). The BMD values of diabetic subjects between groups exhibited a significant gradient difference, with DML < DMM < DMH. On the fitting curves, where BMD in various skeletal regions varied with age, BMDs of DML were approximately 15% lower than those of DMM, and those of DMM were approximately 10% lower than those of DMH. For prevalence and risks of osteoporosis a gradient difference was observed among diabetic groups, DML > DMM approximately control > DMH. The osteoporosis risk was higher for the hip than for the lumbar spine, especially in DML. This study indicated that postmenopausal women with T2DM had higher BMD and lower osteoporosis risk in the lumbar spine, and that lower BMI was an indicator of osteoporosis in mainland China.
在中国内地,绝经后2型糖尿病(T2DM)女性的骨密度(BMD)及其与体重指数(BMI)的关系尚不确定。本研究旨在评估这种关系,纳入了1042例绝经后T2DM女性和919例非糖尿病对照者。采用双能X线吸收法测量腰椎前后位和左髋部的骨密度。糖尿病参与者根据BMI分为三组,即低BMI(DML<18.5kg/m²)、中等BMI(DMM 18.5 - 24.9kg/m²)和高BMI(DMH≥25kg/m²)。各组糖尿病受试者的BMD值呈现出显著的梯度差异,DML<DMM<DMH。在拟合曲线上,不同骨骼区域的BMD随年龄变化,DML的BMD比DMM低约15%,DMM的BMD比DMH低约10%。在糖尿病组中观察到骨质疏松症患病率和风险的梯度差异,DML>DMM≈对照组>DMH。髋部的骨质疏松症风险高于腰椎,尤其是在DML组。本研究表明,绝经后T2DM女性腰椎的BMD较高,骨质疏松症风险较低,且在中国内地,较低的BMI是骨质疏松症的一个指标。