摘要
目的探讨甲状腺功能状态、骨代谢在老年2型糖尿病(T2DM)患者并发骨质疏松症(OP)中的作用。方法选取2022年9月至2023年11月在昆明医科大学第二附属医院收治的139例老年T2DM患者为研究对象,根据是否并发OP,将其分为OP组(n=57)和无OP组(n=82)。收集两组基线资料、骨代谢指标[β胶原降解产物(β-CTX)、总1型胶原氨基端延长肽(P1NP)、甲状旁腺激素(PTH)、骨钙素N端中分子片段(N-MID)等];分析老年T2DM并发OP的影响因素,并分析甲亢、甲减与骨代谢对OP的交互作用。结果OP组T2DM病程长于无OP组,糖化血红蛋白(HbA1c)水平高于无OP组,甲状腺功能状态正常者占比少于无OP组(P<0.05)。OP组β-CTX水平高于无OP组,P1NP、25-羟维生素D[25(OH)D]、N-MID水平低于无OP组(P<0.05)。Logistic回归分析显示,甲状腺功能状态、β-CTX、P1NP、25(OH)D、N-MID是老年T2DM并发OP的独立影响因素(P<0.05);甲亢与β-CTX水平之间、甲减与β-CTX水平之间均存在交互作用。结论老年T2DM合并OP患者骨代谢指标与甲状腺功能状态相关,甲减、甲亢与β-CTX同时暴露可增加T2DM并发OP风险。
Objective To explore the interaction between thyroid function status and bone metabolism in osteoporosis(OP)complicating type 2 diabetes mellitus(T2DM)in elderly patients.Methods A total of 139 elderly patients with T2DM admitted to the Second Affiliated Hospital of Kunming Medical University from September 2022 to November 2023 were enrolled.They were divided into an OP group(n=57)and a non-OP group(n=82)based on whether they had concurrent OP.Baseline data and bone metabolism indicators[β-C-terminal telopeptide of type I collagen(β-CTX),total procollagen type 1 N-terminal propeptide(P1NP),parathyroid hormone(PTH),and N-terminal midfragment osteocalcin(N-MID)]were collected.The influencing factors of OP in elderly T2DM patients were analyzed.And the interaction effects between thyroid dysfunction(hyperthyroidism/hypothyroidism)and bone metabolism on OP were assessed.Results Compared with the non-OP group,the OP group exhibited longer T2DM duration,higher glycated hemoglobin(HbA1c)levels,and a lower proportion of patients with normal thyroid function(P<0.05).The OP group showed elevatedβ-CTX but reduced P1NP,25-hydroxyvitamin D[25(OH)D],and N-MID levels versus the non-OP group(P<0.05).Logistic regression analysis confirmed thyroid function status,β-CTX,P1NP,25(OH)D,and N-MID as independent factors influencing the occurrence of OP in elderly patients with T2DM(P<0.05).Significant interaction effects were observed between hyperthyroidism andβ-CTX,and between hypothyroidism andβ-CTX.Conclusion Bone metabolism markers in elderly T2DM patients with OP correlate with thyroid function status.Concurrent exposure to hypothyroidism/hyperthyroidism and elevatedβ-CTX synergistically increases OP risk in elderly T2DM patients.
作者
杜德财
杨雷
杨惠晶
袁昌丽
李学婷
成继
Du Decai;Yang Lei;Yang Huijing;Yuan Changli;Li Xueting;Cheng Ji(Department of Nuclear Medicine,The Second Affiliated Hospital of Kunming Medical University,Kunming 650031,China)
出处
《成都医学院学报》
2025年第5期827-831,共5页
Journal of Chengdu Medical College
基金
云南省教育厅科学研究基金(No:2019J1260)。
关键词
老年
2型糖尿病
甲状腺功能
骨代谢
交互作用
骨质疏松症
Elderly
Type 2 diabetes mellitus
Thyroid function
Bone metabolism
Interaction
Osteoporosis
