Department of Endocrinology, Peking University International Hospital, Beijing 100001, China.
Biomolecules. 2023 Mar 29;13(4):616. doi: 10.3390/biom13040616.
to analyze the association between blood lipid metabolism and osteoporosis (OP) in older adults with type 2 diabetes mellitus (T2DM).
a total of 1158 older patients with T2DM treated by the Department of Endocrinology, Peking University International Hospital, were retrospectively analyzed, including 541 postmenopausal women and 617 men.
(1) Levels of low-density lipoprotein cholesterol (LDL-C) were significantly higher in the OP group, while levels of high-density lipoprotein cholesterol (HDL-C) were higher in the non-osteoporotic group (both < 0.05). (2) Age, parathyroid hormone (PTH), total cholesterol (TC) and LDL-C were negatively linked to the patients' bone mineral density (BMD) (all < 0.05), while the body mass index (BMI), uric acid (UA) level, HDL-C level and glomerular filtration rate (eGFR) were positively related to their BMD (all < 0.05). (3) In postmenopausal women, after adjustment for other indexes, raised LDL-C is an independent risk factor for OP (OR = 3.38, 95% CI 1.64, 6.98, < 0.05) while raised HDL-C is protective (OR = 0.49, 95% CI 0.24, 0.96, < 0.05). However, raised HDL-C was protective against OP (OR = 0.07, 95% CI 0.01, 0.53, < 0.05).
In older T2DM patients, the effect of blood lipid levels is related to sex. Our study conducted a detailed sex stratification. In addition to seeing the traditional risk factors of OP, such as age, sex, and BMI, we comprehensively analyzed the correlation between the blood glucose level, complications, and blood lipids with OP. HDL-C is a protective factor for OP in both men and women, while LDL-C independently predicts OP in postmenopausal women.
分析老年 2 型糖尿病（T2DM）患者血脂代谢与骨质疏松症（OP）的相关性。
回顾性分析北京大学国际医院内分泌科收治的 1158 例老年 T2DM 患者，其中绝经后女性 541 例，男性 617 例。
（1）OP 组患者的低密度脂蛋白胆固醇（LDL-C）水平显著升高，而非骨质疏松组患者的高密度脂蛋白胆固醇（HDL-C）水平较高（均<0.05）。（2）年龄、甲状旁腺激素（PTH）、总胆固醇（TC）和 LDL-C 与患者的骨密度（BMD）呈负相关（均<0.05），而体质指数（BMI）、尿酸（UA）水平、HDL-C 水平和肾小球滤过率（eGFR）与 BMD 呈正相关（均<0.05）。（3）在绝经后女性中，在校正其他指标后，升高的 LDL-C 是 OP 的独立危险因素（OR=3.38，95%CI 1.64，6.98，<0.05），而升高的 HDL-C 具有保护作用（OR=0.49，95%CI 0.24，0.96，<0.05）。然而，升高的 HDL-C 对 OP 具有保护作用（OR=0.07，95%CI 0.01，0.53，<0.05）。
在老年 T2DM 患者中，血脂水平的作用与性别有关。我们的研究进行了详细的性别分层。除了观察年龄、性别和 BMI 等 OP 的传统危险因素外，我们还综合分析了血糖水平、并发症和血脂与 OP 的相关性。HDL-C 是男性和女性 OP 的保护因素，而 LDL-C 则独立预测绝经后女性的 OP。
