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目的对社区老年居民中糖尿病合并骨质疏松(DOP)人群临床特征及危险因素进行调查,为进一步开展干预提供基线数据和理论依据。方法于2012年10月至2013年10月,采用二阶段随机抽样方法对上海市杨浦区延吉社区2 038例60~90岁常住居民进行病史调查、空腹血糖检测、X线检查及骨密度测试,调查对象分为单纯2型糖尿病(T2DM)、单纯骨质疏松症(OP)、糖尿病合并骨质疏松症(DOP)患者和无糖尿病及骨质疏松者(NORM)组,进行问卷调查、体格检查和实验室检测。应用SPSS 15.0软件进行统计分析,危险因素分析采用logistic回归分析。结果 2 038例调查人群中,资料完整者2 024例,其中T2DM患者228例,占11.26%;OP患者594例,占29.35%;DOP患者111例,占5.49%;NORM组1 091例,占53.90%。DOP组的平均年龄、体重、收缩压、甘油三酯及糖化血红蛋白均高于OP组;平均年龄、高密度脂蛋白胆固醇高于T2DM组,体质指数及糖化血红蛋白低于T2DM组;平均年龄、收缩压及糖化血红蛋白高于NORM组,体质指数低于NORM组,差异均有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,该社区DOP人群的相关因素是糖尿病并发症(OR=20.425,95%CI:12.822~32.536)、性别(OR=3.629,95%CI:2.097~6.279)、高血压史(OR=2.811,95%CI:1.753~4.507)、血钙(OR=2.248,95%CI:1.071~4.720)、骨折史(OR=2.076,95%CI:1.207~3.573)和年龄(OR=1.056,95%CI:1.027~1.087)。结论针对DOP的危险因素,应当对相关人群进行早期诊断和早期干预,以减少骨质疏松骨折的发生。
Objective To investigate the clinical characteristics and risk factors of diabetes mellitus with osteoporosis (DOP) among the elderly residents in the community and provide baseline data and theoretical basis for further intervention. Methods From October 2012 to October 2013, 2 038 permanent residents aged 60-90 years in Yanji Community, Yangpu District, Shanghai were surveyed by two-stage random sampling method. Fasting blood glucose test, X-ray examination and bone mineral density test were performed. The subjects were divided into two groups: simple type 2 diabetes mellitus (T2DM), simple osteoporosis (OP), diabetic patients with osteoporosis (DOP) and non-diabetic and NORM group, questionnaire and physical examination And laboratory testing. SPSS 15.0 software was used for statistical analysis, risk factor analysis using logistic regression analysis. Results Of 2038 cases, there were 2 024 cases with complete data, including 228 with T2DM (11.26%), 594 with OP (29.35%), 111 with DOP (5.49%), and 1 091 with NORM 53.90%. Average age, body weight, systolic blood pressure, triglyceride and HbA1c in DOP group were higher than those in OP group. Mean age, high density lipoprotein cholesterol were higher than those in T2DM group, body mass index and HbA1c were lower than those in T2DM group, mean age, Pressure and glycosylated hemoglobin were higher in the NORM group than in the NORM group, the differences were statistically significant (P <0.05, P <0.01). Logistic regression analysis showed that the related factors of DOP in this community were diabetic complications (OR = 20.425,95% CI: 12.822-32.536), sex (OR = 3.629, 95% CI: 2.097-6.279), history of hypertension (OR = 2.076, 95% CI: 1.207 ~ 3.573) and age (OR = 1.056, P = 95% CI: 1.027 ~ 1.087). Conclusion According to the risk factors of DOP, early diagnosis and early intervention should be performed on the related groups to reduce the incidence of osteoporotic fractures.