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目的探讨老年2型糖尿病患者血脂和骨密度改变的相关性。方法将320例老年2型糖尿病患者按T值分成骨质疏松组和非骨质疏松组,检测腰椎1-4(L1-L4)、股骨颈、Wards三角、大粗隆的骨密度值(BMD)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及其他生化指标。比较两组间各指标的差别,并对骨密度和血脂、年龄等变量之间的关系进行多元逐步回归分析。结果⑴骨质疏松组的TG、体重指数(BMI)低于对照组,HDL-C高于对照组。⑵HDL-C与腰椎1-4(β=-1.192,P=0.019)及大粗隆(β=-0.894,P=0.037)的BMD负相关;年龄与股骨颈的BMD负相关(β=-0.034,P=0.021)。结论老年2型糖尿病患者HDL-C与腰椎及大粗隆BMD负相关,可能是骨质疏松的危险因素。
Objective To investigate the correlation between the changes of blood lipid and bone mineral density in elderly type 2 diabetic patients. Methods 320 elderly patients with type 2 diabetes were divided into osteoporosis group and non-osteoporosis group according to T value. BMD (lumbar spine 1-4, L1-L4, Wards triangle, ), Total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and other biochemical indexes. The differences of each index between the two groups were compared and the multiple stepwise regression analysis was carried out on the relationship between BMD, lipid, age and other variables. Results (1) TG and body mass index (BMI) in osteoporosis group were lower than those in control group, and HDL-C was higher than that in control group. (2) HDL-C was negatively correlated with BMD of lumbar spine 1-4 (β = -1.192, P = 0.019) and greater trochanter (β = -0.894, P = 0.037); age was negatively correlated with BMD of femoral neck , P = 0.021). Conclusion HDL-C in elderly type 2 diabetic patients is negatively correlated with BMD of lumbar spine and greater trochanter, which may be the risk factor of osteoporosis.