【摘要】：目的觀察2型糖尿病合并骨密度減低患者與非骨密度減低患者的血清IGF-1水平,進(jìn)而探討其與2型糖尿病合并骨密度減低的相關(guān)性,為糖尿病合并骨密度減低的防治提供理論依據(jù)。方法依據(jù)1999年WHO糖尿病診斷及分型標(biāo)準(zhǔn)共收集華北理工大學(xué)附屬醫(yī)院內(nèi)分泌科住院治療的214例2型糖尿病患者作為研究對(duì)象。根據(jù)T2DM患者骨密度水平,選取骨密度減低者86例、骨質(zhì)疏松癥者62例為病例組,骨密度正常者66例為對(duì)照組。入組患者均測(cè)定骨密度水平,比較三組患者性別、年齡、糖尿病病程、BMI、胰島素樣生長(zhǎng)因子-1(IGF-1)、糖化血紅蛋白(Hb A1c)、空腹血糖(FPG)、空腹C肽(C-P)、胰島素抵抗指數(shù)(HOMA-IRP)、堿性磷酸酶(ALP)、血鈣(Ca)、血磷(P)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、糖尿病合并癥等指標(biāo)。所有數(shù)據(jù)分析應(yīng)用SPSS21.0統(tǒng)計(jì)軟件分析,正態(tài)分布計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,兩組間比較采用獨(dú)立樣本t檢驗(yàn),多組間比較采用單因素方差分析;計(jì)數(shù)資料采用c2檢驗(yàn);指標(biāo)間的相關(guān)性采用Pearson相關(guān)分析,并得出相關(guān)系數(shù);多因素之間相關(guān)統(tǒng)計(jì)采用多因素非條件logisitc回歸分析、線性相關(guān)分析。檢驗(yàn)水準(zhǔn):P0.05為有統(tǒng)計(jì)學(xué)意義。。結(jié)果1三組T2MD患者性別構(gòu)成通過c2檢驗(yàn)結(jié)果顯示差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2三組T2MD患者年齡構(gòu)成經(jīng)單因素方差分析結(jié)果表明差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3三組T2MD患者IGF-1水平經(jīng)單因素方差分析顯示,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。以患者血清IGF-1225ug/L為暴露,IGF-1≥225ug/L為非暴露,結(jié)果顯示暴露者發(fā)生骨密度減低的危險(xiǎn)性是非暴露者的4倍,而發(fā)生骨質(zhì)疏松的危險(xiǎn)性是非暴露者的19倍,經(jīng)χ2檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。三組間IGF-1水平與性別、年齡、BMI、糖尿病病程、FPG、C-P、Hb Alc、TC、TG、HDL-C、LDL-C、ALP、血Ca、血P、UA的關(guān)系經(jīng)Pearson相關(guān)分析結(jié)果顯示,血清IGF-1水平與病程、TG呈正相關(guān)(P0.05),血清IGF-1水平與年齡、FPG、Hb A1c呈負(fù)相關(guān)(P0.05),IGF-1與性別、BMI、C-P、TC、HDL-C、LDL-C、血Ca、血P、UA無關(guān)。4三組T2MD患者BMI、Hb Alc、FPG、C-P、TC的組間差異有統(tǒng)計(jì)學(xué)意義(P0.005),三組T2MD患者HOMA-IRP、ALP、血Ca、血P、TG、HDL-C、LDL-C、UA的組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。5三組T2MD患者是否合并高血壓病、冠心病、腦梗死、DPN、PVD,經(jīng)c2檢驗(yàn)顯示有統(tǒng)計(jì)學(xué)意義(P0.005)。6以上述單因素分析中具有統(tǒng)計(jì)學(xué)意義的因素為自變量,進(jìn)行多因素非條件二分類logistic回歸分析后結(jié)果顯示血清IGF-1水平與糖尿病患者骨密度減低的關(guān)系仍具有統(tǒng)計(jì)學(xué)意義,進(jìn)一步證實(shí)了血清IGF-1水平與糖尿病患者骨密度減低,當(dāng)IGF-1水平降低,T2DM患者骨密度減低的危險(xiǎn)性增高。結(jié)論1隨著2型糖尿病患者骨密度水平減低,血清IGF-1水平逐漸減低。2低血清IGF-1水平為T2DM患者骨密度減低的危險(xiǎn)因素。
[Abstract]:Objective to observe the serum IGF-1 levels in patients with type 2 diabetes mellitus complicated with reduced bone mineral density (BMD) and to explore the correlation between the level of serum IGF-1 and type 2 diabetes mellitus (T2DM) complicated with decreased bone mineral density (BMD). To provide a theoretical basis for the prevention and treatment of diabetes mellitus complicated with reduced bone mineral density. Methods according to the diagnosis and classification criteria of WHO diabetes in 1999, 214 cases of type 2 diabetes were collected and treated in the Department of Endocrinology, affiliated Hospital of North China University of Science and Technology. According to the level of bone mineral density in T2DM patients, 86 cases of bone mineral density decrease, 62 cases of osteoporosis as case group, 66 cases of normal bone mineral density as control group. The bone mineral density (BMD) was measured in all the patients, and the sex and age of the three groups were compared. BMI, IGF-1, Hb A1c, (FPG), fasting C-peptide (C-P), insulin resistance index (HOMA-IRP), (ALP), (ALP), (Ca), (P), (P), (TC), triglyceride, (TG), high density lipoprotein (HDL-C), fasting blood glucose (FBG), fasting C-peptide (C-P), insulin resistance index (HOMA-IRP). Steroids (HDL-C), low density lipoprotein cholesterol (LDL-C), diabetes mellitus and other indicators. All the data were analyzed by SPSS21.0 statistical software, the normal distribution data were expressed as mean 鹵standard deviation (x 鹵s), the two groups were compared by independent sample t test, the multigroup comparison by single factor analysis of variance, the count data by c2 test. Pearson correlation analysis was used to analyze the correlation among indicators and the correlation coefficient was obtained. The multivariate unconditioned logisitc regression analysis and linear correlation analysis were used to analyze the correlation among multiple factors. The test level of 0. 05 is statistically significant. Results 1 the sex composition of three groups of T2MD patients showed significant difference by c2 test (P0.05). 2 the age composition of three groups of T2MD patients was significantly different by univariate analysis of variance (P0.05). 3 the IGF-1 level of three groups of T2MD patients was significantly higher than that of the control group (P0.05). Factor variance analysis showed that The difference was statistically significant (P0.05). Taking serum IGF-1225ug/L as exposure and IGF-1 鈮，

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