摘要
目的探讨绝经后老年女性2型糖尿病患者下肢动脉硬化与骨密度及其影响因素的相关性。方法选择老年女性2型糖尿病患者142例,平均年龄(70.1±6.4)岁。应用ES-1000SPM多普勒血流探测仪测定踝肱指数(ABI),并检测正位腰椎(L2～4)、双侧股骨颈(neck)、大转子(troch)、华氏三角(Wards)骨密度(BMD);以ABI比值大小分为非外周动脉疾病组(ABI0.9～1.4)和外周动脉疾病组(ABI<0.9)两组。结果外周动脉疾病组的Neck、troch、Wards的BMD值分别为(0.63±0.10)g/cm2、(0.50±0.11)g/cm2、(0.39±0.09)g/cm2,低于非外周动脉疾病组(0.70±0.14)g/cm2、(0.56±0.13)g/cm2、(0.46±0.14)g/cm2,差异有统计学意义(均P<0.05);外周动脉疾病组较非外周动脉疾病组年龄大、糖尿病病程长、收缩压高,血尿素氮、肌酐、微量白蛋白尿值高(均P<0.05)。以neck、troch、WardsBMD值为因变量进行相关分析显示,三者均与年龄呈负相关(r=-0.378、-0.367、-0.410,均P<0.01),与ABI呈正相关(r=0.331、0.327、0.315,均P<0.01)。结论绝经后老年女性2型糖尿病患者下肢动脉病变与骨质疏松密切相关,外周动脉硬化与骨质疏松在老年女性2型糖尿病患者中常同时存在,二者共同的病理生理机制值得关注。
Objective To observe the association between ankle brachial index（ABI） and bone mineral density （BMD） in old female patients with type 2 diabetes mellitus（T2DM）. Methods A total of 142 old female patients with T2DM,with an average age of （70.1±6.4） years, were divided into two groups： peripheral arterial disease （PAD） group and without PAD goup according to ABI, i. e, ABI〈0.9 group and ABI 0.9-1.4 group. ABI, BMD and biochemical indicator of L2-4, neck of femur, greater trochanter（troch） and Wards area in all cases were measured by ES- 1000SPM Doppler blood stream detector and dual energy X-ray absorptiomtry. Results The levels of BMD in neck, troch and Wards in T2DM with PAD （0.63±0.10） g/cm^2,（0.50±0.11） g/cm^2 and （0.39±0.09） g/cm^2 were significantly lower than those in T2DM without PAD （0.70±0.14） g/cm^2 ,（0.56±0.13） g/cm^2 and （0. 465±0.14） g/ cm^2 （all P G0.05）, respectively. Patients with PAD had older age, longer T2DM duration, higher systolic blood pressure,higher urea nitrogen,higher creatinine（Cr） and microalbuminuria than patients without PAD （all P〈0.05）. Multiple linear regression with BMD in neck, troch and Wards as the dependent variables showed that the age was negatively correlated with BMD （ r = -0. 378, -0. 367 and -0.41 respectively, all P〈0.01）, ABI was positively correlated with BMD of neck, troch and Wards （ r = 0.331,0. 327 and 0.315 respectively, all P 〈 0.01 ）. Conclusion This study demonstrates that bone metabolism is associated with vascular structural change. Atherosclerosis and osteoporosis occur at the same time normally, especially in the old female with T2DM. The pathophysiological mechanisms of bone metabolism and vascular structural change should be the concern of further research.
出处
《临床荟萃》
CAS
2009年第13期1130-1132,共3页
Clinical Focus
关键词
糖尿病
2型
动脉硬化
踝肱指数
骨密度
diabetes mellitus, type 2
arteriosclerosis
ankle brachial index
bone mineral density
