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目的 探讨绝经后2型糖尿病(T2DM)患者四肢骨骼肌质量指数(ASMI)与骨质疏松(OP)的相关性。方法 选取164例住院绝经后老年T2DM患者，双能X线吸收法(DXA)测定骨密度(BMD)及四肢骨骼肌肌肉质量，ASMI=四肢骨骼肌肌肉质量/身高2(kg/m2),按T值分为OP组和非OP组，比较两组患者一般资料、生化指标及ASMI并进行Logistic回归、受试者工作特征曲线(ROC)分析。结果 与非OP组比较，OP组肌少症(SAC)患病率高(P<0.05);两组年龄、ASMI、体质指数(BMI)、雌二醇(E2)比较，差异有统计学意义(P<0.05);Logistic回归分析显示ASMI[OR=0.133,95%CI(0.029～0.611)]、BMI[OR=0.785,95%CI(0.625～0.985)]、E2[OR=0.967, 95%CI(0.942～0.993)]是OP的保护因素。ROC曲线提示，ASMI对OP患病预测的曲线下面积为0.752[95%CI(0.632～0.872),P<0.001],敏感性为87.5%,特异性为47.8%,最佳诊断值为5.52 kg/m2。结论 ASMI、BMI、E2减少与OP发生呈正相关，ASMI是OP的重要保护因素，对老年绝经后T2DM患者应早期进行OP筛查及危险因素评估，尽早采取干预措施，降低跌倒、骨折的发生风险。
Abstract：Objective To investigate the correlation between the appendicular skeletal mass index(ASMI) and osteoporosis(OP) in postmenopausal patients with type 2 diabetes(T2DM). Methods 164 hospitalized postmenopausal elderly T2DM patients were selected and their bone density(BMD)and appendicular skeletal mass were measured using dual energy X-ray absorption method(DXA). ASMI=appendicular skeletal mass/height2(kg/m2), and they were divided into OP group and non OP group based on T value. The general clinical data, blood biochemical indicators, and ASMI between the two groups were compared, and Logistic regression analysis, ROC curve were further used to analyze the correlation and diagnostic power. Results Compared with non OP group, OP group had a higher incidence of sarcopenia(SAC)(P<0.05); the differences in age, ASMI, body mass index(BMI), and estradiol(E2) had significant differences between the two groups(P<0.05); Logistic regression analysis showed that the reduction of ASMI [OR=0.133,95%CI(0.029-0.611)], BMI[OR=0.785,95%CI(0.625-0.985)], and E2 [OR=0.967, 95%CI(0.942-0.993)] were protective factors for OP; receiver operating curve(ROC) suggested that the AUC of ASMI for OP prediction was 0.752 [95%CI(0.632-0.872), P<0.001] with sensitivity 87.5%,specificity 47.8%,and the best diagnostic value was 5.52 kg/m2. Conclusion The reduction of ASMI, BMI, and E2 is positively correlated with the occurrence of osteoporosis. ASMI is an important protective factor for osteoporosis. Early OP screening and risk factor assessment should be conducted for elderly postmenopausal T2DM patients, and early intervention measures should be taken to reduce the risk of falls and fractures.
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基本信息:
DOI：10.19405/j.cnki.issn1000-1492.2024.10.025
中图分类号:R587.2;R580;R685
引用信息:
[1]张萍,杜益君,王跃,等.肌少症与绝经后2型糖尿病患者骨质疏松的相关性研究[J].安徽医科大学学报,2024,59(10):1871-1874+1880.DOI:10.19405/j.cnki.issn1000-1492.2024.10.025.
基金信息:
安徽省卫生健康科研项目(编号：AHWJ2023A10010); 安徽医科大学校科研基金项目(编号：2022xkj177)~~
2024-09-30
2024-09-30
2024-09-30