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中国 2 型糖尿病老年住院患者骨代谢指标及骨密度与糖尿病视网膜病变的相关性:一项横断面研究。

Association of Bone Metabolism Indices and Bone Mineral Density with Diabetic Retinopathy in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Inpatient Study in China.

机构信息

Endocrinology Department, Peking University International Hospital, Beijing, China.

Endocrinology Department, Beijing Jishuitan Hospital, Beijing, China.

出版信息

J Diabetes Res. 2021 Jan 12;2021:8853622. doi: 10.1155/2021/8853622. eCollection 2021.

Abstract

OBJECTIVE

This study is aimed at analyzing the association between bone metabolism indices and diabetic retinopathy (DR) in elderly patients with type 2 diabetes mellitus.

METHODS

Data of 352 men and 284 postmenopausal women, aged more than 50 years, with type 2 diabetes mellitus were retrospectively analyzed. Patients were divided into three groups based on the degree of DR: nondiabetic retinopathy (NDR) group, background diabetic retinopathy (BDR) group, and proliferative diabetic retinopathy (PDR) group.

RESULTS

(1) The diabetic duration and urinary albumin to creatinine ratio (UACR) were significantly higher in the PDR and BDR groups than in the NDR group ( < 0.05). The level of beta-C-terminal telopeptide (-CTX) in male patients was lower in the PDR and BDR groups than in the NDR group ( < 0.05). In addition, the level of procollagen 1 intact N-terminal (P1NP) in female patients was higher in the PDR and BDR groups than in the NDR group ( < 0.05). (2) For men and postmenopausal women, the proportion of vitamin deficiency was higher in the PDR and BDR groups than in the NDR group ( < 0.05). (3) The logistic regression analysis in men and postmenopausal women showed that the diabetic duration and lower levels of UACR and 25(OH)D were independent risk factors for DR ( < 0.05). (4) The diabetic duration was also an independent risk factor for PDR ( < 0.05); however, no independent correlation was found between the level of 25(OH)D and PDR ( > 0.05).

CONCLUSIONS

A close association was observed between 25(OH)D level and DR in the elderly male patients and postmenopausal women with type 2 diabetes mellitus. P1NP and -CTX levels might be closely related to DR in elderly male patients and postmenopausal women with type 2 diabetes mellitus.

摘要

目的

本研究旨在分析老年 2 型糖尿病患者骨代谢指标与糖尿病视网膜病变(DR)的相关性。

方法

回顾性分析 352 例男性和 284 例绝经后女性患者的资料,年龄均>50 岁,均患有 2 型糖尿病。根据 DR 程度将患者分为 3 组:无糖尿病视网膜病变(NDR)组、背景性糖尿病视网膜病变(BDR)组和增殖性糖尿病视网膜病变(PDR)组。

结果

(1)与 NDR 组相比,PDR 组和 BDR 组患者的糖尿病病程和尿白蛋白与肌酐比值(UACR)更高(均<0.05),男性患者的β-C 末端肽(β-CTX)水平更低(均<0.05),女性患者的前胶原 1 完整 N 端(P1NP)水平更高(均<0.05)。(2)男性和绝经后女性患者中,PDR 组和 BDR 组维生素缺乏比例均高于 NDR 组(均<0.05)。(3)男性和绝经后女性患者的 logistic 回归分析显示,糖尿病病程、UACR 水平和 25(OH)D 水平较低是 DR 的独立危险因素(均<0.05)。(4)糖尿病病程也是 PDR 的独立危险因素(均<0.05);而 25(OH)D 水平与 PDR 之间无独立相关性(>0.05)。

结论

在老年 2 型糖尿病男性患者和绝经后女性患者中,25(OH)D 水平与 DR 密切相关。P1NP 和 β-CTX 水平可能与老年 2 型糖尿病男性患者和绝经后女性患者的 DR 密切相关。

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