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老年2型糖尿病患者骨代谢异常的影响因素

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目的 调查襄阳市老年2型糖尿病(T2DM)患者骨代谢异常现状,并分析其影响因素.方法 选择 2020 年 1 月至2022年1月襄阳市中心医院就诊的1236例老年T2DM患者为研究对象,发放调查问卷,统计骨质疏松(OP)发生率.根据患者骨密度检测结果,将确诊为OP的患者分为OP组(n=374),未确诊OP但骨密度下降者分为骨密度下降组(n=266),骨密度正常者分为对照组(n=596).采用SPSS 20.0统计软件进行数据分析.根据数据类型,分别采用t检验或 χ2 检验进行组间比较.采用有序多分类logistic回归分析老年T2DM患者发生骨代谢异常的影响因素.结果 1236 例老年T2DM患者中,374 例确诊为OP(30.26%).有序多分类logistic回归分析结果显示,年龄≥80 岁(OR=3.710,95%CI 1.588~8.668)、女性(OR=3.586,95%CI 1.831~7.024)、T2DM病程≥13年(OR=2.563,95%CI 1.994~3.293)、糖化血红蛋白>9.0%(OR=2.197,95%CI 1.137~4.244)及低密度脂蛋白胆固醇≥4.1 mol/L(OR=3.401,95%CI 1.362~8.494)是影响老年T2DM患者骨代谢状态的危险因素;体质量指数≥24.0 kg/m2(OR=0.493,95%CI 0.318~0.765)及25-羟基-维生素D3≥30μg/L(OR=0.381,95%CI 0.235~0.617)是其保护因素.结论 襄阳市老年T2DM患者OP及骨密度下降检出率与全国平均水平相当,注重老年T2DM患者骨密度检查,同时积极控制血糖、参加体育锻炼、加强维生素D摄入,在改善老年T2DM患者骨代谢异常中具有一定意义.
Influencing factors of abnormal bone metabolism in elderly patients with type 2 diabetes mellitus
Objective To investigate the status quo of abnormal bone metabolism in elderly patients with type 2 diabetes mellitus(T2DM)in Xiangyang City,and to analyze its influencing factors.Methods Totally1 236 elderly patients with T2DM admitted to Xiangyang Central Hospital from January 2020 to January 2022 were selected as the study subjects.Questionnaires were distributed to calculate the incidence rate of osteoporosis(OP)and understand the status quo of osteoporosis in elderly T2DM population in Xiangyang City.The patients with OP were assigned as OP group(n=374),the patients with decreased bone mineral density were classified as the decreased bone mineral density group(n=266),and the patients with normal bone mineral density were set as control group(n=596).The influencing factors of OP in elderly T2DM population in Xiangyang City were explored.SPSS statistics 20.0 was used for data analysis.t test or Chi-square test was performed for comparison between groups according to the data types.Ordinal multivariate logistic regression analysis was used to analyze the related factors affecting the occurrence of abnormal bone metabolism in elderly patients with T2DM.Results Among 1 236 elderly patients with T2DM,374 cases(30.26%)were diagnosed with OP.Ordinal multivariate logistic regression analysis showed that age≥80 years(OR=3.710,95%CI 1.588-8.668),female(OR=3.586,95%CI 1.831-7.024),T2DM course≥13 years(OR= 2.563,95%CI 1.994-3.293),glycosylated hemoglobin A1c>9.0%(OR=2.197,95%CI 1.137-4.244),and low-density lipoprotein cholesterol≥4.1 mol/L(OR=3.401,95%CI 1.362-8.494)were risk factors affecting bone metabolism status in elderly patients with T2DM,and body mass index≥24.0 kg/m2(OR=0.493,95%CI 0.318-0.765)and 25-hydroxy vitamin D3≥30 μg/L(OR=0.381,95%CI 0.235-0.617)were protective factors.Conclusion The detection rates of OP and bone mass loss in elderly patients with T2DM in Xiangyang City are similar to the national average level.Paying attention to bone mineral density examination in elderly patients with T2DM,actively controlling blood glucose,participating in physical exercise and strengthening vitamin D intake are of certain signifi-cance in improving abnormal bone metabolism in elderly patients with T2DM.

agedosteoporosisdiabetes mellitus,type 2

王明春、郭锐

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湖北文理学院附属医院·襄阳市中心医院 内分泌科,湖北 襄阳 441021

湖北文理学院附属医院·襄阳市中心医院 公共卫生处,湖北 襄阳 441021

老年人 骨质疏松症 糖尿病,2型

湖北省自然科学基金重点项目

2022CFA020

2024

中华老年多器官疾病杂志
中国人民解放军总医院老年心血管病研究所

中华老年多器官疾病杂志

CSTPCD
影响因子:0.728
ISSN:1671-5403
年,卷(期):2024.23(2)
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