2型糖尿病绝经后患者腰椎体积骨密度与内脏脂肪/皮下脂肪组织比率的相关性分析

Association between bone mineral density and visceral adipose tissue/subcutaneous adipose tissue ratio in postmenopausal women with type 2 diabetes

关键词:  2型糖尿病  定量CT  内脏脂肪组织  皮下脂肪组织  骨密度

Key words:  type 2 diabetes mellitus  quantitative CT  visceral adipose tissue  subcutaneous adipose tissue  bone mineral density

摘要:

目的 探讨绝经后2型糖尿病患者腹部脂肪分布与骨密度的关系。方法 收集71例绝经后2型糖尿病患者临床资料。定量CT(quantitative CT, QCT)测定腰椎L1～L3体积骨密度（volume bone mineral density, vBMD）及相应层面的腹部内脏脂肪（visceral adipose tissue, VAT）和皮下脂肪（subcutaneous adipose tissue, SAT）含量。根据平均骨密度，将患者分为成骨量正常组（N组）、骨量减少组（T组）及骨质疏松组（O组）。多因素线性回归分析VAT/SAT及年龄、体质量指数（body mass index, BMI）、内脏脂肪、空腹血糖、胰岛素抵抗指数（HOMA-RI）与L1～L3 vBMD的相关性。结果 O组的年龄、VAT、HOMA-RI、VAT/SAT与N组相比差异有统计学意义（P＜0.05）；T组的年龄、HOMA-RI、VAT/SAT与N组相比差异有统计学意义（P＜0.05）。单因素分析显示，在L1～L3 vBMD与年龄、FBG、VAT、VAT/SAT（r值分别为-0.446，-0.514，-0.469）、HOMA-RI呈负相关（P＜0.05），与体质量指数无相关性（P＞0.05）。多因素回归分析显示L1～L3 vBMD与年龄（β值分别为-0.502、-0.501、-0.438），均P＜0.05及VAT/SAT（β值分别为-29.52、-29.56、-21.89，均P＜0.05）呈负相关。结论 绝经后的2型糖尿病患者VAT/SAT和年龄是骨密度下降的危险因素。

Abstract:

Objective To investigate the association between bone mineral density and visceral adipose tissue/subcutaneous adipose tissue ratio (VAT/SAT) in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods The clinical data of 71 postmenopausal patients with T2DM were collected. Quantitative CT (QCT) was used to measure the volume bone mineral density (vBMD) of lumbar spine L1～L3, and the VAT/SAT. According to the average bone mineral density, patients were divided into normal bone mass group (N group), osteopenia group (T group) and osteoporosis group (O group). Multivariate linear regression was used to analyze the association among VAT/SAT, age, body mass index (BMI), visceral fat, fasting blood glucose, insulin resistance index (HOMA-IR) and L1～L3 vBMD. Results There were significant differences in age, VAT, HOMA-IR, VAT/SAT between N group and O group (P＜0.05); and between T group and N group (P＜0.05). Univariate analysis showed that L1～L3 vBMD was negatively correlated with age, FBG, VAT, VAT/SAT (r=-0.446,-0.514,-0.469), and HOMA-IR (P＜0.05), but not correlated with BMI. Multivariate linear regression showed that L1～L3 vBMD was negatively correlated with age (β: -0.502,-0.501, -0.438, P＜0.05) and VAT/SAT (β: -29.52, -29.56, -21.89, P＜0.05). Conclusion VAT/SAT and age are the risk factors of reducing bone mineral density in postmenopausal women with T2DM.