【摘要】 目的观察高血压和糖尿病患者的骨密度变化,探讨骨密度与高血压、糖脂代谢紊乱等的相关性。方法561例就诊者分为4组:正常组108例,高血压组101例,糖尿病组183例,糖尿病并高血压组169例。检测血压、血糖、血脂等,计算体质量指数(BMI),检测骨代谢标志物。双能X线骨密度仪检测正位脊柱及股骨骨密度。结果在正常组中,骨代谢异常(骨量减少+骨质疏松)的发生率为25.0%。在单纯高血压组中,骨代谢异常的发生率为38.6%。在糖尿病组中,骨代谢异常的发生率为47.5%,而在糖尿病并高血压组中,骨代谢异常的发生率为54.4%(χ~2=25.43,P<0.01)。多元逐步回归分析显示,年龄、总胆固醇、糖化血红蛋白(HbA1c)与正位脊柱骨密度呈负相关,BMI、血尿酸与正位脊柱骨密度呈正相关。年龄、总胆固醇、血清Ⅰ型胶原交联C端肽(CTX)与股骨骨密度呈负相关,BMI与股骨骨密度呈正相关。舒张压与正位脊柱骨密度、股骨骨密度均有相关性,但非独立相关。结论年龄、总胆固醇、HbA1c、血尿酸、CTX是骨质疏松的危险因素。BMI与正位脊柱骨密度及股骨骨密度呈正相关,舒张压虽与正位脊柱骨密度及股骨骨密度相关,但非独立相关。更多还原

【Abstract】 Objective To observe the changes of bone mineral density(BMD)in patients with hypertension and diabetes mellitus,and to explore the correlation between BMD and metabolic disorders such as hypertension and hyperglycemia. Methods A total of 561 subjects were divided into 4 groups:108 cases in normal group,101 cases in hypertension group,183 cases in diabetic group and 169 cases in diabetic and hypertension group. Blood pressure,blood glucose,blood lipids were measured,body mass index(BMI)was calculated,and bone metabolism markers were detected. Dual energy X-ray absorptiometry was used to detect anteroposterior spine and femur BMD.Results In the normal group,the incidence of abnormal bone metabolism(osteopenia+osteoporosis)was 25.0%.In the hypertension group,the incidence of abnormal bone metabolism was 38.6%.In the diabetic group,the incidence of abnormal bone metabolism was 47.5%. While in the diabetic and hypertensive group,the incidence of abnormal bone metabolism was 54.4%(χ~2=25.43,P<0.01). According to multivariate stepwise regression analysis,age,total cholesterol(Tch),and hemoglobin A1c(HbA1c)were negatively correlated with BMD of anteroposterior spine,while BMI and serum uric acid were positively correlated with BMD of anteroposterior spine. Age,Tch,type 1 collagen cross-linked C-telopeptide(CTX)was negatively correlated with femur BMD,and BMI was positively correlated with femur BMD. Diastolic blood pressure was positively correlated with anteroposterior spine BMD and femoral BMD but not independently. Conclusion Age,Tch,HbA1c,serum uric acid and CTX were the risk factors of osteoporosis.BMI was positively correlated with spine BMD and femoral BMD. Diastolic blood pressure was correlated with anteroposterior spine BMD and femoral BMD,but not independent.更多还原