2型糖尿病患者VSR与骨质疏松及骨折的相关性分析OA
Correlation of VSR with osteoporosis and fractures in patients with type 2 diabetes mellitus
目的 探讨 2型糖尿病(T2DM)患者内脏脂肪面积与骨骼肌质量比值(VSR)与骨质疏松(OP)及骨折风险的关系.方法 本研究对象为 2022年 1月至 2023 年 3月在兰州大学第一医院内分泌科住院的 549例 T2DM患者.采用双能 X 线骨密度仪(DXA)测量腰椎及髋部 BMD.采用生物电阻抗分析仪测量内脏脂肪面积(VFA)和四肢骨骼肌质量(ASM),计算 VSR.根据 OP诊断标准,将患者分为骨量正常组、骨量减少组和 OP组;根据 VSR 四分位,将患者分为 Q1~Q4组.比较 4组 BMD、OP患病率和椎体骨折风险.采用多因素 Logistic回归分析 VSR与 OP及骨折风险的关系.结果 OP 组 VSR较骨量正常组和骨量减少组升高(均 P<0.05).青年组、中年组和老年组患者的BMD、VSR差异有统计学意义(均 P<0.05).BMD 随 VSR增加呈现先升后降的倒 U 型变化,在 Q2组达到最高,而在 Q4组降至最低.高 VSR水平与较高的腰椎 OP患病率相关,且女性 OP患病率在各组中均高于男性(均 P<0.05).多因素 Logistic 回归分析显示,患者 VSR 与 OP、骨折风险无关(P>0.05);中年组中,VSR 与 OP 患病风险呈正相关(均 P<0.05).结论 中年 T2DM患者中,VSR升高与 OP 患病风险相关,可作为该特定人群骨退化与代谢失衡的早期预警指标.
Objective To investigate the relationship of the visceral fat area to skeletal muscle mass ratio(VSR)with osteoporosis(OP)and fracture risk in patients with type 2 diabetes mellitus(T2DM).Methods A total of 549 patients with T2DM who were hospitalized in the Department of Endocrinology,the First Hospital of Lanzhou University,from January 2022 to March 2023 were included in this study.Lumbar spine and hip bone mineral density(BMD)were measured by dual-energy X-ray absorptiometry(DXA).Visceral fat area(VFA)and appendicular skeletal muscle mass(ASM)were measured by bioelectrical impedance analysis,and VSR was calculated.According to the diagnostic criteria for OP,the patients were divided into the normal bone mass group,osteopenia group and OP group.According to VSR quartiles,the patients were divided into Q1 to Q4 groups.BMD,the prevalence of OP and the risk of vertebral fracture were compared among the four groups.Multivariable Logistic regression analysis was used to examine the relationship of VSR with OP and fracture risk.Results VSR was higher in the OP group than those in the normal bone mass group and osteopenia group(both P<0.05).Differences in BMD and VSR among the young,middle-aged and elderly groups were statistically significant(all P<0.05).With increasing VSR,BMD showed an inverted U-shaped trend,reaching the highest level in the Q2 group and the lowest level in the Q4 group.A high VSR level was correlated with a higher prevalence of lumbar OP,and the prevalence of OP in women was higher than that in men across all groups(all P<0.05).Multivariable Logistic regression analysis showed that VSR was not correlated with OP or fracture risk in the overall population(P>0.05).In the middle-aged group,VSR was positively correlated with the risk of OP(all P<0.05).Conclusion In middle-aged patients with T2DM,an increased VSR is correlated with the risk of OP and may serve as an early warning indicator of bone degeneration and metabolic imbalance in this specific population.
王梦宇;贺雯;魏敬怡;曾孺宗;刘丽娟;尹鸿涛;车红霞;甄东户
兰州大学第一临床医学院,兰州 730000兰州大学第一临床医学院,兰州 730000兰州大学第一临床医学院,兰州 730000兰州大学第一临床医学院,兰州 730000兰州大学第一医院内分泌科,兰州 730000兰州大学第一医院内分泌科,兰州 730000甘肃省第三人民医院内分泌科,兰州 730000兰州大学第一临床医学院,兰州 730000||兰州大学第一医院内分泌科,兰州 730000
2型糖尿病内脏脂肪面积与骨骼肌质量比值内脏脂肪面积骨密度骨质疏松骨折
Type 2 diabetes mellitusVisceral fat area to skeletal muscle mass ratioVisceral fat areaBone mineral densityOsteoporosisFractures
《新医学》 2026 (5)
480-490,11
甘肃省科技计划(重点研发计划-社会发展领域)(23YFFA0032)四大慢病重大专项(2023ZD0508402)
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