Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, 57035-030 Maceió, Alagoas, Brazil.
J Diabetes Complications. 2011 Jul-Aug;25(4):216-21. doi: 10.1016/j.jdiacomp.2011.02.004. Epub 2011 Mar 31.
Controversial data suggest that patients with type 2 diabetes mellitus have an increased risk of fractures despite having, in some studies, higher bone mineral density.
The aim of this study was to determine the prevalence of osteoporosis and morphometric vertebral fractures in 148 postmenopausal diabetic women, aged 61.87±7.85 years, and their relationship with clinical and metabolic factors and chronic complications of the disease.
The prevalence of osteoporosis was 30.4% at lumbar spine (LS) and 9.5% at femoral neck (FN). The prevalence of vertebral fractures was 23%, mostly mild and located at the thoracic spine. Patients with fractures were older (P<.001), had been in the menopause for a long period (P=.005), had lower creatinine clearance (P=.026) had and lower bone mineral density at LS (P=.01) and FN (P=.042). The frequency of fractures increased with age (P<.001), with the duration of the disease (P=.037) and with the presence of retinopathy (P=.030). In patients with fractures, the prevalence of osteoporosis increased to 40% at LS (P=.004) and to 35.7% at FN (P=.049). After logistic regression adjustment, it was observed that the likelihood of presenting vertebral fractures was significantly increased at the age of 60 years or older (P<.001) and with the presence of osteoporosis at LS (P=.006), irrespective of blood glucose control.
We found a high prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus, irrespective of blood glucose control, and these conditions were more frequent in long-standing disease and in patients with retinopathy and impaired renal function.
本研究旨在确定 148 例年龄 61.87±7.85 岁的绝经后 2 型糖尿病女性的骨质疏松症和骨量计量性椎体骨折的患病率，并探讨其与临床和代谢因素以及疾病慢性并发症的关系。
本研究旨在确定 148 例年龄 61.87±7.85 岁的绝经后 2 型糖尿病女性的骨质疏松症和骨量计量性椎体骨折的患病率，并探讨其与临床和代谢因素以及疾病慢性并发症的关系。
腰椎（LS）骨质疏松症的患病率为 30.4%，股骨颈（FN）为 9.5%。椎体骨折的患病率为 23%，主要为轻度骨折，位于胸腰椎。骨折患者年龄较大（P<.001），绝经时间较长（P=.005），肌酐清除率较低（P=.026），LS（P=.01）和 FN（P=.042）的骨密度较低。骨折的发生率随年龄增加而增加（P<.001），随疾病持续时间增加（P=.037），随视网膜病变存在而增加（P=.030）。在骨折患者中，LS 骨质疏松症的患病率增加到 40%（P=.004），FN 为 35.7%（P=.049）。经逻辑回归校正后，发现 60 岁或以上年龄（P<.001）和 LS 骨质疏松症（P=.006）的患者发生椎体骨折的可能性显著增加，与血糖控制无关。
我们发现，无论血糖控制如何，绝经后 2 型糖尿病女性均存在较高的骨质疏松症和椎体骨折发生率，且这些情况在疾病长期存在、伴有视网膜病变和肾功能受损的患者中更为常见。
