中国骨质疏松杂志2024，Vol.30Issue(12) ：1757-1762.DOI:10.3969/j.issn.1006-7108.2024.12.007

50岁以上男性T2DM患者骨骼肌质量与骨代谢标志物、骨密度的关系

The relationship between skeletal muscle mass and bone metabolic markers and bone mineral density in male patients with T2DM over 50 years old

昝晓晖 陈重阳 赵阳婷 李凯 王亚雯 郭馨远 韩梅 马邓荣 刘靖芳
中国骨质疏松杂志2024，Vol.30Issue(12) ：1757-1762.DOI:10.3969/j.issn.1006-7108.2024.12.007
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  • 万方数据

50岁以上男性T2DM患者骨骼肌质量与骨代谢标志物、骨密度的关系

The relationship between skeletal muscle mass and bone metabolic markers and bone mineral density in male patients with T2DM over 50 years old

昝晓晖 1陈重阳 1赵阳婷 1李凯 1王亚雯 1郭馨远 1韩梅 1马邓荣 1刘靖芳2
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作者信息

  • 1. 兰州大学第一临床医学院,甘肃兰州 730000
  • 2. 兰州大学第一临床医学院,甘肃兰州 730000;兰州大学第一医院内分泌科,甘肃兰州 730000
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摘要

目的 分析50岁以上男性2型糖尿病患者骨骼肌质量指数与骨代谢标志物、骨密度的相关性.方法 选取2022年1月至2023年4月兰州大学第一医院内分泌科住院的398例年龄≥50岁的男性T2DM患者,根据ASMI水平分为肌肉质量减少组(n=181)和肌肉质量正常组(n=217),比较两组患者血清骨代谢标志物骨钙素(osteocalcin,OC)、β-胶原特殊序列(type Ⅰcollagen carboxyl-terminal peptide β,β-CTX)、Ⅰ 型胶原氨基端肽(type Ⅰ procollagen amino-terminal Peptide,PINP)、股骨颈、全髋、腰椎1～4(L1～4)BMD水平的差异,Pearson/Spearman相关性及Logistic回归分析ASMI与BMD之间的相关性.结果 与肌肉质量正常组相比,肌肉质量减少组骨量减少/骨质疏松患病率显著增高[19(8.8％)vs 36(19.9％),P=0.001],股骨颈、全髋、L1～4 BMD水平显著降低(P＜0.05).股骨颈、全髋、L1～4 BMD水平与OC、PIPN、β-CTx均呈负相关(P＜0.05),与ASMI呈正相关(P＜0.05).以是否存在骨量减少/骨质疏松症为因变量,ASMI作为自变量,调整混杂因素后,ASMI与骨量减少/骨质疏松症的发病风险独立负相关[OR=0.540,9 5％CI(0.306～0.953),P＜0.05],而β-CTx与骨量减少/骨质疏松症的发病风险独立正相关[OR=1.002,95％CI(1.000～1.004),P＜0.05].结论 50岁以上男性T2DM患者骨骼肌质量减少、高β-CTx水平与骨量减少/骨质疏松的发生显著相关.

Abstract

Objective To analyze the relationship between Appendicular skeletal muscle mass index(ASMI)and bone metabolism markers,bone mineral density(BMD)in male patients with type 2 diabetes over 50 years old.Methods A total of 398 male patients with type 2 diabetes mellitus who were 50 years of age or older and were admitted to the Department of Endocrinology at the First Hospital of Lanzhou University between January 2022 and April 2023 were included in the study,and were categorized into a reduced muscle mass group(n=181)and a normal muscle mass group(n=217)based on their ASMI levels.A comparison was made between the serum bone metabolism markers osteocalcin(OC),β-collagen specific sequence(Type Ⅰ collagen carboxyl-terminal peptide β,β-CTX),and Type Ⅰ collagen amino-terminal peptide(PINP)levels of patients in two groups.Additionally,the BMD levels of the femoral neck,hip,lumbar vertebrae 1-4(L1-4)were compared.Pearson/Spearman correlation and logistic regression were used to analyze correlations between ASMI and BMD.Results The study found a significantly higher prevalence of osteopenia/osteoporosis in the group with reduced muscle mass compared to the group with normal muscle mass(19[8.8％]vs.36[19.9％],P=0.001).Additionally,the group with reduced muscle mass exhibited significantly lower BMD levels in the femoral neck,hip and L1-4 areas(P＜0.05).Femoral neck,hip,L1-4 BMD levels were negatively correlated with OC,PIPN,and β-CTx(P＜0.05)and positively correlated with ASMI(P＜0.05).After adjusting for confounders,ASMI was found to be independently and negatively associated with the risk of developing osteopenia/osteoporosis[OR=0.540,95％CI(0.306,0.953),P＜0.05],while β-CTx was independently and positively associated with the risk of developing osteopenia/osteoporosis[OR=1.002,95％CI(1.000,1.004),P＜0.05].Conclusion In male T2DM patients over 50 years old,a reduction in skeletal muscle mass and elevated levels of β-CTx are identified as significantly associated with the development of osteopenia/osteoporosis.

关键词

2型糖尿病/骨骼肌质量指数/骨代谢标志物/骨密度/骨质疏松

Key words

type 2 diabetes/skeletal muscle mass index/bone metabolic markers/bone mass density/osteoporosis

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出版年

2024
中国骨质疏松杂志
中国老年学和老年医学学会

中国骨质疏松杂志

CSTPCDCSCD北大核心
影响因子：1.439
ISSN：1006-7108
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