本文選題：2型糖尿病 + 骨質疏松癥　； 參考：《華北理工大學》2015年碩士論文

【摘要】：目的探討2型糖尿病(T2DM)患者脂代謝紊亂與骨質疏松的關系,為糖尿病合并骨質疏松的防治提供相關理論依據(jù)。方法選取華北理工大學附屬醫(yī)院內分泌科住院的2型糖尿病患者185例,男性91例,女性94例,年齡范圍37~70歲,平均年齡56.10±7.10歲。根據(jù)骨密度測定結果分為骨質疏松癥組71例,其中男性22例,女性49例,年齡波動在37~70歲,平均58.13±6.66歲,無骨質疏松癥組114例,其中男性69例,女性45例,年齡波動在37~70歲,平均54.84±7.11歲。入組患者均測定腰椎前后位總體(L1-4)面積BMD,比較兩組性別、年齡、體重指數(shù)(BMI),收縮壓、舒張壓,空腹血糖(FPG)、餐后2小時血糖(2h PG)、血清總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、超敏C反應蛋白(hs-CRP)等指標,所有數(shù)據(jù)分析應用IBM SPSS19.0統(tǒng)計軟件包進行統(tǒng)計分析,正態(tài)分布計量資料以均數(shù)±標準差(x±s)表示,組間均數(shù)比較采用獨立樣本t檢驗;計數(shù)資料采用百分率表示,組間率的比較采用卡方檢驗;2型糖尿病合并骨質疏松的危險因素采用多因素非條件Logistic回歸分析,各指標對骨密度的影響采用多元線性回歸分析。結果兩組間經卡方檢驗顯示骨質疏松癥組女性較無骨質疏松癥組所占比例高(P=0.0000.05),骨質疏松癥組與無骨質疏松癥組年齡比較,骨質疏松癥組高于無骨質疏松癥組,差異有統(tǒng)計學意義(P=0.0140.05)。骨質疏松癥組與無骨質疏松癥組收縮壓、舒張壓、FPG、2h PG、hs-CRP比較差異無統(tǒng)計學意義(P0.05)。骨質疏松癥組與無骨質疏松癥組BMI比較,骨質疏松癥組低于無骨質疏松癥組差異有統(tǒng)計學意義(P=0.0090.05)。骨質疏松癥組與無骨質疏松癥組TC、LDL-C比較,骨質疏松癥組高于無骨質疏松癥組,差異有統(tǒng)計學意義(P=0.0410.05、P=0.0000.05)。兩組間TG、HDL-C比較差異無統(tǒng)計學意義(P0.05)。經卡方檢驗顯示骨質疏松癥組LDL-C3.61mmol/L所占比例高于無骨質疏松癥組,差異有統(tǒng)計學意義(P0.05)。以是否合并骨質疏松為因變量,以性別、年齡、體重指數(shù)、TC、TG、HDL-C、LDL-C為自變量進行多因素非條件Logistic回歸分析,LDL-C、性別、年齡為2型糖尿病患者合并骨質疏松的獨立相關因素(P0.05),體重指數(shù)為T2DM患者骨密度的保護因素。多元線性回歸分析顯示,LDL-C、性別、年齡與T2DM患者骨密度呈負相關,而BMI與T2DM患者骨密度呈正相關。結論高LDL-C水平是T2DM患者合并骨質疏松癥的獨立相關因素。
[Abstract]:Objective to investigate the relationship between lipid metabolism disorder and osteoporosis in patients with type 2 diabetes mellitus (T2DM), and to provide theoretical basis for the prevention and treatment of diabetes mellitus complicated with osteoporosis. Methods 185 patients with type 2 diabetes mellitus (91 males and 94 females), aged 3770 years, with an average age of 56.10 鹵7.10 years, were selected from the Endocrinology Department of affiliated Hospital of North China University of Technology. According to the results of bone mineral density measurement, 71 cases of osteoporosis were divided into male 22 cases, female 49 cases, the age fluctuating from 37 to 70 years old, mean 58.13 鹵6.66 years old, 114 cases of no osteoporosis group, male 69 cases, female 45 cases, the age fluctuation was 3770 years old. Mean 54.84 鹵7.11 years old. The total area of L1-4) in the anterior and posterior lumbar vertebrae was measured. Sex, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) were compared between the two groups. Fasting blood glucose (FPG), 2 hours postprandial glucose and 2 h PGN, serum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), hypersensitive C-reactive protein (hs-CRP), and so on. All the data were analyzed by IBM SPSS19.0 statistical software package. The measurement data of normal distribution are expressed as mean 鹵standard deviation (x 鹵s), the comparison of mean among groups is expressed by independent sample t test, and the counting data is expressed as percentage. The risk factors of type 2 diabetes mellitus complicated with osteoporosis were analyzed by multivariate Logistic regression analysis and multiple linear regression analysis were used to analyze the effect of each index on bone mineral density (BMD). Results the chi-square test between the two groups showed that the proportion of female in osteoporosis group was higher than that in no osteoporosis group. The age of osteoporosis group was higher than that of no osteoporosis group, and the age of osteoporosis group was higher than that of no osteoporosis group. The difference was statistically significant (P = 0.0140.05). There was no significant difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between osteoporosis group and osteoporosis group (P 0.05). The BMI of osteoporosis group was significantly lower than that of no osteoporosis group (P 0.0090.05). Compared with those without osteoporosis, the LDL-C of osteoporosis group was higher than that of no osteoporosis group, and the difference was statistically significant (P < 0.05). There was no significant difference in HDL-C between the two groups (P 0.05). Chi-square test showed that the proportion of LDL-C3.61mmol/L in osteoporosis group was higher than that in no osteoporosis group, the difference was statistically significant (P 0.05). Using sex, age and body mass index (BMI) as independent variables, multivariate Logistic regression analysis was carried out to determine the sex. The age of type 2 diabetic patients with osteoporosis was independent of P0. 05 and BMI was the protective factor of bone mineral density in patients with T2DM. Multiple linear regression analysis showed that LDL-C, sex and age were negatively correlated with bone mineral density (BMD) in T2DM patients, while BMI was positively correlated with BMD in T2DM patients. Conclusion High LDL-C level is an independent risk factor for osteoporosis in T2DM patients.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.1;R580

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