【摘要】 目的探讨跟骨定量超声在中老年2型糖尿病(type 2 diabetes mellitus,T2DM)并发骨质疏松症的应用价值。方法选取2018年6月至10月在湖南省湘潭市中心医院住院诊断为T2DM的中老年患者200例,其中男性106例,女性94例。运用跟骨定量超声(quantitative ultrasound,QUS)和双能X线吸收测量仪(dual energy X-ray absorptiometry,DXA)进行测量,以DXA测量的诊断结果为金标准,分析定量超声参数—宽带超声衰减(broadband ultrasound attenuation,BUA)、宽带超声声速(speed of sound,SOS)、骨硬化指数(stiffness index,STI)及T值与DXA参数—腰椎1-4骨密度、股骨颈骨密度、髋部整体骨密度的相关性,绘制受试者工作曲线(receiver operating characteristic curve,ROC)。结果无论男性还是女性,跟骨定量超声参数与DXA测量的各部位骨密度均为正相关,男性相关系数(r)为0.366～0.671,女性相关系数(r)为0.285～0.613;跟骨定量超声T值无法用于预测诊断男性腰椎骨质疏松症(P>0.05),可用于预测诊断女性腰椎骨质疏松症、男性和女性髋部骨质疏松症,其阈值分别为-1.35、-2.40和-1.55 (P<0.05)。结论跟骨定量超声对于预测中老年T2DM人群的骨质疏松症具有一定价值,其诊断阈值根据性别、骨密度测量部位的不同而有所不同。更多还原

【Abstract】 Objective To evaluate the value of calcaneus quantitative ultrasound(QUS) in screening osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus.Methods From June to October 2018,200 patients including 106 males and 94 females diagnosed as type 2 diabetes mellitus in Hunan Xiangtan Central Hospital were enrolled.Bone mineral density of lumbar spine and proximal hip was measured by dual energy X-ray absorptiometry(DXA).The calcaneus of the patient was investigated by QUS.Results The parameters of QUS were positively correlated with bone mineral density at the sites of lumbar spine and proximal hip in both genders.The correlation coefficients were ranged from 0.366 to 0.671 in male,while in female they were ranged from 0.285 to 0.613.The T value of calcaneus could not be used to screen osteoporosis at lumbar spine in male,but could be used to screen osteoporosis at lumbar spine in female,and femoral osteoporosis in male and female with the cutoff value as -1.35,-2.40,and -1.55,respectively(P< 0.05).Conclusion Quantitative ultrasound has certain value for screening osteoporosis in middle-aged and elderly patients with type 2 diabetes mellitus.更多还原