摘要
目的 探讨糖尿病肾病患者骨代谢指标与脑血管疾病的相关性及其对生存率的影响.方法 选取2014年1月-2019年12月在首都医科大学宣武医院内分泌科就诊的996例2型糖尿病肾病老年患者作为研究对象.根据是否合并脑血管疾病分为合并组599例和未合并组397例.收集患者的一般资料、临床资料、实验室资料、骨代谢资料和随访资料.采用logistic回归分析骨代谢指标(骨密度、骨钙素、骨碱性磷酸酶、维生素D、甲状旁腺激素等)与脑血管疾病的相关性.结果 合并组的骨密度、维生素D均低于未合并组,骨钙素、骨碱性磷酸酶均高于未合并组,合并组的血钙及磷水平均低于未合并组,差异均有统计学意义(P＜0.05).多因素logistic回归分析显示,骨密度、维生素D等是影响脑血管疾病发生的保护因素(P＜0.05),骨碱性磷酸酶是其危险因素(P＜0.05).结论 糖尿病肾病患者的骨代谢指标是影响脑血管疾病发生的预测因素或介导因素,为糖尿病肾病患者的骨代谢和脑血管系统的评估和干预提供了新的依据和思路.
Abstract
Objective To investigate the correlation between bone metabolism indicators and cerebrovascular diseases in patients with diabetic nephropathy and their impact on survival rate.Methods A total of 996 elderly patients with type 2 diabetic ne-phropathy who visited the department of endocrinology,Xuanwu Hospital,Capital Medical University from January 2014 to December 2019 were selected as the study subjects and divided into the combined group(n=599)and the uncombined group(n=397)accord-ing to the presence or absence of cerebrovascular disease.General data,clinical data,laboratory data,bone metabolism data and fol-low-up data of the patients were collected.Logistic regression was used to analyze the association between bone metabolism indicators(bone mineral density,osteocalcin,bone alkaline phosphatase,vitamin D,parathyroid hormone,etc.)and cerebrovascular dis-ease.Results Bone mineral density and vitamin D in the combined group were lower than those in the uncombined group;osteocal-cin and bone alkaline phosphatase were higher than those in the uncombined group;serum calcium and phosphorus levels in the com-bined group were lower than those in the uncombined group,and the differences were statistically significant(P＜0.05).Multivari-ate logistic regression analysis showed that bone mineral density and vitamin D were protective factors affecting the occurrence of cere-brovascular diseases(P＜0.05),and bone alkaline phosphatase was a risk factor(P＜0.05).Conclusion Bone metabolism indi-cators in patients with diabetic nephropathy are predictive or mediating factors affecting the occurrence of cerebrovascular disease,pro-viding a new basis and ideas for the evaluation and intervention of bone metabolism and cerebrovascular system in patients with diabetic nephropathy.
基金项目
国家重点研发计划主动健康和老龄化科技应对重点专项项目(2020)(2020YFC2005505)
维普
万方数据