新疆维汉两族2型糖尿病患者骨密度测定结果分析

摘要

Objective To compare the difference of bone mineral density ( BMD) between Uygur and Han patients with type 2 diabetes mellitus (T2DM) in Xinjiang, and to analyze the influential factors, in order to provide basis for the diagnosis and the treatment of osteoporosis. Methods A total of 233 Uygur and Han patients with T2DM, who were hospitalized in the Department of Endocrinology, the First Affiliated Hospital of Xinjiang Medical University, were selected. All the patients were divided into 4 groups according to ethnicity and gender : Uygur male group, Uygur female group, Han male group, and Han female group. The general data of all the patients were recorded. BMD of the lumbar vertebrae and the proximal femur was detected using Lexos dual energy X -ray absorptiometry (DEXA, MDS Co. Ltd, France). Meanwhile, serum biomechanical indexes were detected. Results BMD of L1-4 and the left femur of T2DM patients in both Uygur and Han groups, including males and females, showed no statistical difference ( P ＞ 0. 05 ). Whereas, BMD of L1 -2 in Uygur male group was higher than that in Han male group ( P ＜ 0. 05) ; and BMD of L1 in Han female group was higher than that in Uygur female group ( P ＜ 0. 05). BMD of the femur of T2DM patients was negatively correlated with age, duration, years of menopause, and glycosylated hemoglobin ( HbA1c), and was positively correlated with BMI, insulin sensitivity index ( ISI), and homeostasis model assessment insulin secretion index ( HMOA-ISI). No correlation with serum biochemical indexes was observed. Taking age as control factor, BMD of female T2DM patients was negatively correlated with the year of menopause, but was not correlated with the age of menopause. Conclusion BMD of T2DM patients in both Uygur and Han nationality in Xinjiang shows no significant difference according to the overall comparison of ethnicity and gender. But the BMD of L1-2 in Uygur male group is higher than that in Han male group, and BMD of L1 in Han female group is higher than that in Uygur female group. BMD of the femur is negatively correlated with age, duration, and HbA1c. In female T2DM patients, BMD is negatively correlated with the year of menopause.%目的 对比新疆维、汉族2型糖尿病(T2DM)患者骨密度(Bone mineral density,BMD)的差异并对其影响因素进行分析,为临床骨质疏松症的诊治工作提供依据.方法 选取入住新疆医科大学第一附属医院内分泌科的维、汉两族T2DM患者233例,按族别及性别分为4组(维吾尔族男性组、维吾尔族女性组、汉族男性组和汉族女性组),记录一般资料,运用法国MDS公司生产的Lexxos型双能X线骨密度仪(Duel energy X-ray absorptiometry,DXA)测定其腰椎前后位及左侧股骨近端BMD,同时测定血清学指标.结果①腰椎L1- L4、左侧股骨BMD在T2DM维吾尔族与汉族、维吾尔族男性组与汉族男性组、维吾尔族女性组与汉族女性组之间相比无统计学意义(P＞0.05),但在L1、L2椎体之间,维吾尔族男性组高于汉族男性组(P＜0.05),在L1椎体,汉族女性组高于维吾尔族女性组(P＜0.05).② T2DM患者股骨BMD与年龄、病程、绝经年数、糖化血红蛋白(glycosylated hemoglobin,HbA1c)成负相关,与体重指数(body mass index,BMI)、胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛素分泌指数(Homeostesis Model Assessment Insulin secretion index,HMOA-ISI)成正相关,与血清学指标无关.将年龄做为控制因子,女性T2DM患者BMD与绝经年龄无关,与绝经年限负相关.结论① 新疆维、汉族BMD按民族、性别总体比较未见明显差异,但在L1、L2椎体之间,维吾尔族男性组高于汉族男性组(P＜0.05),在L1椎体,汉族女性组高于维吾尔族女性组.② 年龄、病程、HbA1c与T2DM患者股骨BMD负相关,绝经年限与女性T2DM患者BMD负相关.