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目的探讨糖代谢异常的代谢综合征(MS)患者骨密度(BMD)与体脂百分含量(%fat)的特点。方法随机选取门诊符合标准的老年患者,完成问卷调查、生化、骨代谢相关指标测定,双能X线吸收法测定BMD及%fat。按中国糖尿病学会(Chinese Diabetes Society,CDS)的MS诊断标准,分为MS组与非MS(NMS)组,按WHO骨质疏松(OP)的诊断标准分为骨量正常组,低骨量组及OP组。比较组间差异,分析MS相关危险因素。结果该人群MS患病率为69.03%,,骨质疏松的患病率为7.74%,低骨量患病率为35.48%。MS组骨量正常的百分率高于NMS组,骨质疏松的百分率低于NMS组,P值接近0.05(P=0.06)。MS组各部分%fat均高于NMS组(P<0.01)。在骨量正常、低骨量、OP三组间,年龄逐渐增大(P<0.01),BMI在OP组显著低于其他两组,A区%fat与G区%fat比值(A/G)在正常组显著高于OP组(P<0.01)。Spearman相关分析显示,MS与股骨颈、全髋、腰椎各部位BMD的相关系数分别为0.11、0.13、0.17,但只有腰椎达到统计学差异(P<0.05)。MS与A区%fat,G区%fat,全身%fat以及A/G相关系数分别为0.53,0.33,0.51,0.24,P值均<0.01。logistic逐步回归分析显示,BMI,A区%fat和Cr为MS的独立危险因素。结论该组人群MS以及骨量异常(OP及低骨量)患病率高。MS患者BMD和A区%fat、A/G高于NMS患者,OP患病率低于NMS患者。代表腹部脂肪聚集的A区%fat是MS的独立危险因素。
Objective To investigate the characteristics of bone mineral density (BMD) and body fat percentage (% fat) in patients with metabolic syndrome (MS) with abnormal glucose metabolism. Methods Elderly patients were selected randomly from outpatients to complete the questionnaire survey, biochemical and bone metabolism related indexes, and BMD and% fat were measured by dual-energy X-ray absorptiometry. According to the MS diagnostic criteria of Chinese Diabetes Society (CDS), MS patients were divided into MS group and non-MS group. According to WHO diagnostic criteria for osteoporosis (OP), the patients were divided into normal group, And OP group. Differences between groups were compared to analyze MS-related risk factors. Results The prevalence of MS in this population was 69.03%. The prevalence of osteoporosis was 7.74% and the prevalence of low bone mass was 35.48%. The percentage of normal bone mass in MS group was higher than that in NMS group, the percentage of osteoporosis was lower than that in NMS group, P value was close to 0.05 (P = 0.06). % Fat in each part of MS group was higher than that of NMS group (P <0.01). (P <0.01). The BMI in OP group was significantly lower than that in the other two groups (A / G) In the normal group was significantly higher than the OP group (P <0.01). Spearman correlation analysis showed that the correlation coefficient between MS and femoral neck, total hip and lumbar spine BMD were 0.11,0.13,0.17 respectively, but only the lumbar spine reached statistical significance (P <0.05). The correlation coefficient between MS and A area% fat, G area% fat, whole body% fat and A / G were 0.53,0.33,0.51,0.24, P <0.01 respectively. Logistic stepwise regression analysis showed that% BMI and A% fat and Cr were independent risk factors for MS. Conclusion The prevalence of MS and abnormal bone mass (OP and low bone mass) in this population is high. MS patients with BMD and A fat%, A / G higher than NMS patients, OP prevalence lower than NMS patients. Area A fat, representing abdominal fat accumulation, is an independent risk factor for MS.