| 摘要: |
| 目的 探讨新疆绝经后2型糖尿病（T2DM）女性患者脂质代谢与骨密度（BMD）的关系。方法 纳入136例新疆绝经后女性，并分为糖耐量正常伴骨量正常组（对照组，26例）、糖耐量正常伴骨量异常组（骨量异常组，28例）、T2DM伴骨量正常组（T2DM组，27例）及T2DM伴骨量异常组（55例）。记录各组年龄、身高等基线资料，采用罗氏全自动生物化学分析仪测定血钙、血磷、碱性磷酸酶（ALP）、三酰甘油、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C），用双能X线测定腰椎L1～L4、股骨颈、髋关节BMD。结果 T2DM伴骨量异常组患者年龄、绝经年限均高于对照组（Z均=-2.54，P均<0.05），骨量异常组、T2DM组各项基线指标与对照组相比差异均无统计学意义（P均>0.05）。T2DM组和T2DM伴骨量异常组的空腹血糖（Z=-4.08、-5.87， P均<0.01）和糖化血红蛋白（Z=-4.59、-6.33，P均<0.01）水平均高于对照组；T2DM伴骨量异常组的脂质代谢指标三酰甘油低于对照组（Z=-2.01，P<0.05）。骨量异常组和T2DM伴骨量异常组腰椎L1～L4（Z=-6.23、-6.84， P均<0.01）、股骨颈（Z=-5.32、-4.30，P均<0.01）、髋关节（Z=-5.44、-5.00，P均<0.01）BMD均低于对照组。调整年龄、绝经年限混杂因素影响后行偏相关分析结果显示，82例绝经后T2DM女性患者的腰椎L1～L4、股骨颈、髋关节BMD与BMI（r=0.209、0.623、0.265，P=0.015、0.002、0.002）、三酰甘油（r=0.298、0.233、0.273，P<0.001、P=0.007、P=0.001）呈正相关，股骨颈、髋关节BMD与HDL-C呈负相关（r=-0.191、-0.200，P=0.027、0.021）。结论 在新疆绝经后T2DM女性患者中，HDL-C升高及三酰甘油降低与BMD下降有关，这可能促进了骨质疏松症的发生。 |
| 关键词: 绝经后女性 2型糖尿病 脂质代谢 骨密度 |
| DOI：10.16781/j.0258-879x.2020.05.0574 |
| 投稿时间：2020-01-01修订日期：2020-02-14 |
| 基金项目:2018年度兵团科技发展专项（2018BB040），石河子大学成果转化与技术推广项目（CGZH201911）． |
|
| Relationship between lipid metabolism and bone mineral density in postmenopausal women with type 2 diabetes mellitus in Xinjiang |
| ZHAO Hui-rong1,LI Si-yuan2,LI Jun1*,WANG Shuang3,SHI Yan-qiu4,LI Jia-jia1,GAO Qun1 |
(1. Department of Endocrinology and Metabolism, The First Affiliated Hospital, Shihezi University School of Medicine, Shihezi 832000, Xinjiang Uygur Autonomous Region, China;
2. Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Ministry of Education, Shihezi 832000, Xinjiang Uygur Autonomous Region, China;
3. Department of Endocrinology and Metabolism, Central Hospital of Yangpu District, Shanghai 200090, China;
4. Department of Cardiovascular Medicine, Zhejiang Xiaoshan Hospital, Hangzhou 311200, Zhejiang, China
*Corresponding author) |
| Abstract: |
| Objective To explore the relationship between lipid metabolism and bone mineral density (BMD) in postmenopausal women with type 2 diabetes mellitus (T2DM) in Xinjiang. Methods A total of 136 postmenopausal women in Xinjiang were included and divided into four groups:normal glucose tolerance with normal bone mass group (control group, 26 cases), normal glucose tolerance with abnormal bone mass group (abnormal bone mass group, 28 cases), T2DM with normal bone mass group (T2DM group, 27 cases), and T2DM with abnormal bone mass group (55 cases). The age, height and other baseline data of each group were recorded. Blood calcium, blood phosphorus, alkaline phosphatase (ALP), triacylglycerol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured by Roche automatic biochemical analyzer. The BMD of L1-L4, femoral neck and hip joint were measured by dual energy X-ray. Results The age and menopause years of T2DM with abnormal bone mass group were significantly higher than those of the control group (both Z=-2.54, both P<0.05). There were no significant difference in baseline indexes between abnormal bone mass group or T2DM group and control group (all P>0.05). The fasting blood glucose (Z=-4.08, -5.87, both P<0.01) and hemoglobin (Z=-4.59, -6.33, both P<0.01) levels in T2DM group and T2DM with abnormal bone mass group were higher than those in the control group; the lipid metabolism index triacylglycerol in T2DM with abnormal bone mass group was lower than that in the control group (Z=-2.01, P<0.05). The BMD of L1-L4 (Z=-6.23, -6.84, both P<0.01), femoral neck (Z=-5.32, -4.30, both P<0.01), and hip joint (Z=-5.44, -5.00, both P<0.01) in abnormal bone mass group and T2DM with abnormal bone mass group were lower than those in the control group. After adjusting the influence of age and menopause years, the results of partial correlation analysis showed that L1-L4, femoral neck and hip joint BMD were positively correlated with body mass index (r=0.209, 0.623, 0.265, P=0.015, 0.002, 0.002) and triacylglycerol (r=0.298, 0.233, 0.273, P<0.001, P=0.007, P=0.001), femoral neck and hip joint BMD were negatively correlated with HDL-C (r=-0.191, -0.200, P=0.027, 0.021) in 82 postmenopausal women with T2DM. Conclusion The elevated HDL-C and decreased triacylglycerol are associated with decreased BMD, which may promote the occurrence of osteoporosis in postmenopausal women with T2DM in Xinjiang. |
| Key words: postmenopausal women type 2 diabetes mellitus lipid metabolism bone density |
