Al-Homood Ibrahim Abdulrazag, Sheshah Iman, Mohammed Abdel Gaffar A, Gasim Gasim I
Medical Specialties Department, Rheumatology Section, King Fahad Medical City, Riyadh, Saudi Arabia.
Diabetic Center, King Salman Hospital, Riyadh, Saudi Arabia.
Open Access Maced J Med Sci. 2017 Apr 8;5(2):177-181. doi: 10.3889/oamjms.2017.030. eCollection 2017 Apr 15.
This study aimed to assess the prevalence and determinants of osteoporosis [lumbar spine (LS) and femoral neck (FN)] among patients with type 2 diabetes at King Salman Hospital.
One hundred seventy patients with type 2 diabetes were enrolled in this cross-sectional study in the period from the 1st of January until the 1st of July 2015. Patient selection was based on self-report of the previous diagnosis by a physician, being on an antidiabetic agent, or a fasting glucose of 126 mg/dl as per the American Diabetes Association criteria. A dual energy X-ray absorptiometry scan with the bone mineral density (BMD) categorization based on the WHO cut of levels of T-scores and determination of vitamin D levels were performed. A detailed questionnaire was used to collect demographic data.
Out of 170 participants, 50 (29.4%) were diagnosed as having osteoporosis, while 68 (40%) were diagnosed with osteopenia. Age was determined as a risk factor for a decreased BMD in patients with osteopenia (odds ratio (OR) = 1.1, 95% confidence interval (CI) = (1.0-1.1), p = 0.039) and osteoporosis (OR = 1.1, CI = 1.0-1.2, p < 0.001). Similarly, oral hypoglycemic agents (OHA) increased the risk of decreased BMD in osteopenia (OR = 2.6; CI = 1.0-6.7; p = 0.023) as well as osteoporosis, (OR = 3.8; CI = 1.3-10.9; p = 0.013), while vitamin D deficiency increased the risk of osteopenia OR = 3.0; CI = 1.2-7.2; p = 0.012). Increased BMI decreased the risk of both osteopenia and osteoporosis (OR = 0.9; CI = 0.9-0.99; p = 0.031 vs. OR = 0.9; CI = 0.80-0.95; p = 0.003).
Advanced age, OHA and vitamin D deficiency are determinants of decreased BMD in Saudi women with type 2 diabetes, while an increased BMI protects against low BMD.
本研究旨在评估沙特国王萨勒曼医院2型糖尿病患者骨质疏松症（腰椎和股骨颈）的患病率及其决定因素。
2015年1月1日至7月1日期间，170例2型糖尿病患者纳入本横断面研究。患者选择基于医生先前诊断的自我报告、正在使用抗糖尿病药物或根据美国糖尿病协会标准空腹血糖为126mg/dl。进行双能X线吸收法扫描，并根据世界卫生组织T值水平切点对骨密度（BMD）进行分类，同时测定维生素D水平。使用详细问卷收集人口统计学数据。
170名参与者中，50例（29.4%）被诊断为骨质疏松症，68例（40%）被诊断为骨质减少。年龄被确定为骨质减少患者（比值比（OR）=1.1，95%置信区间（CI）=（1.0 - 1.1），p = 0.039）和骨质疏松症患者（OR = 1.1，CI = 1.0 - 1.2，p < 0.001）骨密度降低的危险因素。同样，口服降糖药（OHA）增加了骨质减少患者（OR = 2.6；CI = 1.0 - 6.7；p = 0.023）以及骨质疏松症患者（OR = 3.8；CI = 1.3 - 10.9；p = 0.013）骨密度降低的风险，而维生素D缺乏增加了骨质减少的风险（OR = 3.0；CI = 1.2 - 7.2；p = 0.012）。体重指数（BMI）增加降低了骨质减少和骨质疏松症的风险（OR = 0.9；CI = 0.9 - 0.99；p = 0.031对比OR = 0.9；CI = 0.80 - 0.95；p = 0.003）。
高龄、口服降糖药和维生素D缺乏是沙特2型糖尿病女性骨密度降低的决定因素，而体重指数增加可预防低骨密度。
