1型糖尿病患者骨密度的变化及相关因素分析

目的：观察1 型糖尿病患者骨密度（bone mineral density，BMD）的变化及其影响因素。方法：采用双能X 线骨密度仪测定108 例1 型糖尿病患者及106 例非糖尿病人群腰椎1 至4（L1、L2、L3、L4、、L1-4 总体）及左侧髋部（股骨颈、大转子、ward＇s 三角、股骨干及左髋总体）骨密度，同时测定受试者年龄、身高、体重、腰围、臀围，1 型糖尿病患者病程、糖化血红蛋白（HbA1c）等指标，利用多元回归分析1型糖尿病患者骨密度的相关因素。结果：L1-4 总体BMD 和左髋总体BMD 与年龄、HbA1c 呈负相关，与BMI呈正相关（P〈0.05）；左髋总体BMD 与性别有关（P〈0.05）。结论：1型糖尿病患者BMD 低于对照人群，1型糖尿病患者的性别、年龄、BMI、HbA1c 水平与BMD 关系密切。

A Study of Bone Mineral Density and its Determinants in Type 1 Diabetes Mellitus

Objective： To explore the changes of the bone mineral density （BMD） and the relationship between BMD and clinical related factors in type 1 diabetic patients. Methods： BMD in lumbar spine and hip in 108 type 1 diabetic patients and 106 control subjects were measured by using Dual-energy X-ray Absorptiometry （DXA）. In all subjects, age, height, body weight, waistline, hips were measured, in type 1 diabetic patients, Diabetes duration and HbAlc were assessed. Results： BMDs of lumbar 1 （L1）, lumbar 2 （L2）, lumbar 3（L3）, lumbar 4 （IA）, lumbar 1-4 （L1-4） total, Neck, Troeh, ward＇s, Trunk and hip total were significantly lower in type 1 diabetic patients than control subjects. In type 1 diabetic patients, there were significant positive correlation between body mass index （BMI） and BMDs of L1, L2, L1-4 total, Neck, Troch, Tnmk and hip total. In type-1 diabetic patients, HbAlc level and age was negatively correlated and BMI was positively correlated with L1-4 total BMD and left hip total BMD （P〈0.05）. Gender was correlated with left hip total BMD （P〈0.05）. Conclusions： BMD of type 1 diabetic patients were significantly lower than that of control subjects. Gender, age, BMI and HbAlc were related to the BMD in type 1 diabetic patients.