Zhong Ni, Zhang Youyang, Pu Xiangling, Xu Bei, Xu Mingxin, Cai Haidong, Zhang Ge, Cui Ran, Sheng Hui, Qu Shen
1 Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
2 Department of Endocrinology and Metabolism, The Second People's Hospital of Kunshan, Kunshan, P.R. China.
Diab Vasc Dis Res. 2018 Sep;15(5):433-441. doi: 10.1177/1479164118779386. Epub 2018 Jun 12.
Type 2 diabetes mellitus complicated with microvascular diseases can be used as a model to study the relationship between bone health and the microvascular situation.
A total of 2,170 patients with type 2 diabetes mellitus (1,188 postmenopausal females and 982 males aged ⩾50 years) were included in our cross-sectional study. These patients were grouped according to 24-hour urine protein level: Group I (<30 mg), Group II (30-299 mg) and Group III (≥300 mg). Bone mineral density of the lumbar spine, hip and femoral neck was evaluated by dual-energy X-ray absorptiometry. Fundus oculi photography for diabetic retinopathy and 24-h urine protein for diabetic nephropathy were used as markers of microangiopathy in type 2 diabetes mellitus. Characteristics of the patients and bone mineral density were compared. Multivariate analysis was used to study the association between bone mineral density and microangiopathy. Statistical analysis was performed using SPSS 20.0. p < 0.05 was considered statistically significant.
Group III had the lowest bone mineral density level in both genders. Multivariate analysis revealed that microangiopathy was negatively correlated with bone mineral density in females (lumbar: r = -0.522, p < 0.001; hip: r = -0.301, p = 0.010; femoral neck: r = -0.314, p = 0.009), but not in males, after adjustment for age, body mass index, hypertension, hyperlipidemia, diabetic status, hepatic function, kidney function, sex hormones and 25(OH) vitamin D.
These results demonstrate an independent negative correlation between microangiopathy and bone mineral density in postmenopausal female type 2 diabetes mellitus patients.
2型糖尿病合并微血管疾病可作为研究骨骼健康与微血管状况之间关系的模型。
共有2170例2型糖尿病患者（1188例绝经后女性和982例年龄≥50岁的男性）纳入我们的横断面研究。这些患者根据24小时尿蛋白水平分组：I组（<30mg）、II组（30 - 299mg）和III组（≥300mg）。采用双能X线吸收法评估腰椎、髋部和股骨颈的骨密度。糖尿病视网膜病变的眼底照相和糖尿病肾病的24小时尿蛋白作为2型糖尿病微血管病变的标志物。比较患者的特征和骨密度。采用多变量分析研究骨密度与微血管病变之间的关联。使用SPSS 20.0进行统计分析。p < 0.05被认为具有统计学意义。
III组在两性中骨密度水平最低。多变量分析显示，在调整年龄、体重指数、高血压、高脂血症、糖尿病状态、肝功能、肾功能、性激素和25(OH)维生素D后，微血管病变与女性骨密度呈负相关（腰椎：r = -0.522，p < 0.001；髋部：r = -0.301，p = 0.010；股骨颈：r = -0.314，p = 0.009），但与男性无关。
这些结果表明绝经后2型糖尿病女性患者的微血管病变与骨密度之间存在独立的负相关。
