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比较潜伏自身免疫性糖尿病男性患者与经典 1 型和 2 型糖尿病男性患者的骨密度,探讨骨质疏松的危险因素。

Comparing the bone mineral density among male patients with latent autoimmune diabetes and classical type 1 and type 2 diabetes, and exploring risk factors for osteoporosis.

机构信息

Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China.

出版信息

J Endocrinol Invest. 2021 Aug;44(8):1659-1665. doi: 10.1007/s40618-020-01472-6. Epub 2021 Jan 2.

DOI:10.1007/s40618-020-01472-6
PMID:33387352
Abstract

AIMS

This study aimed to compare the bone mineral densities (BMDs) among male patients with latent autoimmune diabetes in adults (LADA), classical type 1 diabetes (T1DM), and type 2 diabetes (T2DM), and to examine the risk factors for developing low BMD in these patients.

PATIENTS AND METHODS

Between January 2017 and October 2020, a total of 57, 67, and 223 male patients with LADA, classical T1DM, and T2DM, respectively, were recruited from the endocrinology department of Shanghai Tenth People's Hospital. Hormonal markers of bone metabolism, lipid profiles, uric acid, glycosylated hemoglobin A1c (HbA1c), and beta-cell function were measured using blood samples. BMD was measured at the lumbar spine, femoral neck, and right hip by dual-energy X-ray absorptiometry.

RESULTS

The mean BMD values from all three skeletal sites in male patients with LADA were comparable to those with classical T1DM but were much lower than those with T2DM. After adjusting for confounding factors, multiple linear regression analysis demonstrated that in all male patients with diabetes, body mass index (BMI), uric acid, and fasting C-peptide showed significant positive associations with BMD at all three skeletal sites; however, osteocalcin showed a negative association at all three sites.

CONCLUSIONS

Compared with male patients with T2DM, lower BMDs were observed in patients with LADA and T1DM. Low BMI, uric acid, C-peptide levels, and high osteocalcin levels are risk factors for developing low BMD in male patients with diabetes.

摘要

目的

本研究旨在比较成年隐匿性自身免疫性糖尿病(LADA)、经典 1 型糖尿病(T1DM)和 2 型糖尿病(T2DM)男性患者的骨矿物质密度(BMD),并探讨这些患者发生低 BMD 的危险因素。

方法

2017 年 1 月至 2020 年 10 月,我们从上海第十人民医院内分泌科共招募了 57、67 和 223 名分别患有 LADA、经典 T1DM 和 T2DM 的男性患者。使用血液样本测量骨代谢激素标志物、血脂谱、尿酸、糖化血红蛋白 A1c(HbA1c)和β细胞功能。采用双能 X 射线吸收法测量腰椎、股骨颈和右侧髋部的 BMD。

结果

LADA 男性患者的所有三个骨骼部位的平均 BMD 值与经典 T1DM 患者相当,但明显低于 T2DM 患者。在校正混杂因素后,多元线性回归分析表明,在所有糖尿病男性患者中,体重指数(BMI)、尿酸和空腹 C 肽与所有三个骨骼部位的 BMD 呈显著正相关;然而,骨钙素与所有三个部位均呈负相关。

结论

与 T2DM 男性患者相比,LADA 和 T1DM 男性患者的 BMD 较低。低 BMI、尿酸、C 肽水平和高骨钙素水平是男性糖尿病患者发生低 BMD 的危险因素。

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