2 型糖尿病老年男性骨密度与亚临床周围动脉疾病的相关性。
Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus.
机构信息
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
出版信息
Osteoporos Int. 2022 Aug;33(8):1715-1724. doi: 10.1007/s00198-022-06404-z. Epub 2022 Apr 22.
UNLABELLED
The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip.
PURPOSE
To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L) in elderly men with type 2 diabetes mellitus (T2DM).
METHODS
We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score < - 1.0).
RESULTS
Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm, P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075-74.222], P = 0.043). CONCLUSION: Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.
目的
探讨 2 型糖尿病（T2DM）老年男性亚临床周围动脉疾病（PAD）与全髋关节、股骨颈和腰椎（L）骨密度（BMD）的关系。
方法
本回顾性横断面研究共纳入 2466 例确诊糖尿病患者，其中 272 例年龄≥55 岁的 T2DM 男性（50 例亚临床 PAD，222 例无 PAD）纳入分析。采用偏相关分析探讨踝肱指数（ABI）与 BMD 的关系。采用多变量 logistic 回归分析探讨低骨密度（T 评分<−1.0）的影响因素。
结果
与对照组相比，T2DM 合并亚临床 PAD（ABI≤0.9）患者的全髋关节 BMD 和 T 评分显著降低（BMD：0.87±0.14 比 0.92±0.15 g/cm，P=0.014；T 评分：−1.30[−1.70 至−0.45]比−0.80[−1.40 至 0.00]，P=0.009）。偏相关分析表明 ABI 与全髋关节 T 评分显著相关（校正 r=0.166，P=0.009）。logistic 回归分析表明，亚临床 PAD 是全髋关节骨密度降低的独立危险因素（校正比值比[95%可信区间]：8.933[1.075-74.222]，P=0.043）。
结论
亚临床 PAD（ABI≤0.9）可作为年龄≥55 岁 T2DM 男性全髋关节 BMD 降低的危险因素，为该人群全髋关节低骨密度的早期发现提供临床线索。
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