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目的探讨围绝经期血糖偏高女性血脂、血压与骨密度降低的相关性。方法选取2012年1月-2014年10月在该院体检的128例围绝经期血糖偏高女性为观察组,根据骨密度情况再分为骨密度降低组(60例)和骨密度正常组(68例)。选取同期来该院体检的56例无糖代谢异常的围绝经期女性为对照组。检测各组血糖、血脂、血压等相关生化指标并比较不同组别之间的差异,分析骨质疏松的影响因素。结果观察组女性血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压明显高于对照组,差异有统计学意义(t值分别为6.859、7.051、6.167、5.580、7.769、6.910,均P<0.05);骨密度降低组女性年龄、TC、LDL-C明显高于骨密度正常组,而体重指数(BMI)、双股骨骨密度、腰椎1~4骨密度明显低于骨密度正常组,差异有统计学意义(t值分别为5.391、5.660、6.614、5.927、8.904、7.741,均P<0.05)。对照组女性年龄越大双股骨及腰椎1~4骨密度越低(r值分别为-0.273、-0.263,均P<0.05),而血糖、血脂、血压与骨密度无关(r值分别为1.230、1.187、1.460,均P>0.05);观察组女性年龄、TC及LDL-C越高,双股骨骨密度越低(r值分别为-0.281、-0.315、-0.282,均P<0.05),而腰椎1~4骨密度与年龄、TC呈负相关(r值分别为-0.232、-0.312、-0.245,均P<0.05)。多因素Logistic分析显示,年龄、TC、LDL-C、收缩压是围绝经期血糖偏高发生的独立危险因素。结论围绝经期血糖偏高女性骨密度降低的发生与年龄、TC、LDL-C、收缩压密切相关,应严格控制上述除年龄之外的影响因素以降低骨质疏松的发生率。
Objective To investigate the correlation between serum lipids, blood pressure and bone mineral density in peri-menopausal women with high blood sugar. Methods From January 2012 to October 2014, 128 women with hyperglycemia in perimenopausal period undergoing physical examination in our hospital were selected as the observation group. According to the bone mineral density, we divided them into two groups: the group with reduced bone density (60 cases) and the group with normal bone density 68 cases). Fifty-six cases of perimenopausal women without abnormal glucose metabolism during the same period were selected as the control group. Blood glucose, blood lipids, blood pressure and other biochemical indicators were detected in each group and the differences between different groups were compared to analyze the influencing factors of osteoporosis. Results The blood glucose, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and systolic blood pressure in the observation group were significantly higher than those in the control group (t = 6.859,7.051,6.167,5.580,7.769, respectively) , 6.910, all P <0.05). The age, TC and LDL-C of the women with decreased bone mineral density were significantly higher than those with normal BMD, while the body mass index (BMI), double femur BMD and lumbar BMD 1 ~ The BMD of the normal group, the difference was statistically significant (t values were 5.391,5.660,6.614,5.927,8.904,7.741, all P <0.05). The higher the females age was, the lower the BMD of femoral and lumbar spines was (P <0.05, -0.273, -0.263, P <0.05 respectively), while the blood glucose, blood lipid and blood pressure were not related to BMD , 1.187,1.460, all P> 0.05). The higher the TC, LDL-C and TC of the observation group, the lower the BMD of the femur (r = -0.281, -0.315, -0.282, The lumbar spine 1 ~ 4 bone mineral density and age, TC was negatively correlated (r values were -0.232, -0.312, -0.245, all P <0.05). Multivariate Logistic analysis showed that age, TC, LDL-C, and systolic blood pressure were independent risk factors for high blood glucose in perimenopausal period. Conclusions The reduction of bone mineral density in peri menopausal women with high blood sugar levels is closely related to age, TC, LDL-C and systolic blood pressure. The factors other than age mentioned above should be strictly controlled to reduce the incidence of osteoporosis.