成年男性胰岛素抵抗与骨密度、骨微结构的相关性分析OA
Analysis of insulin resistance with bone mineral density and microstructure in adult males
目的 探讨成年男性胰岛素抵抗与骨密度(BMD)、骨微结构的相关性.方法 回顾性选取2018年1月至2021年7月在南京医科大学第一附属医院老年内分泌科检查的中国成年男性作为研究对象,收集口服葡萄糖耐量试验、BMD、骨小梁分数(TBS)的检查结果,利用稳态模型计算胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)及反映全身胰岛素敏感性的Matsuda指数等指标.采用多元线性回归分析探讨各代谢指标与BMD、TBS的相关性.结果 共纳入283名成年男性,体重指数(BMI)(r=0.279,P<0.001)、空腹胰岛素水平(r=0.174,P=0.003)、HOMA-IR(r=0.184,P=0.002)均与BMD呈正相关,Matsuda指数与BMD呈负相关(r=-0.157,P=0.008);低密度脂蛋白胆固醇(r=-0.136,P=0.022)、HOMA-β(r=-0.140,P=0.018)、HOMA-IR(r=-0.160,P=0.007)均与TBS呈负相关,Matsuda指数与TBS呈正相关(r=0.156,P=0.009).多元线性回归分析结果显示,调整年龄、BMI、血脂等因素后,HOMA-IR及Matsuda指数与BMD无相关性(P>0.05);HOMA-IR仍与TBS呈负相关(β=-0.143,P=0.039),且Matsuda指数与TBS呈正相关(β=0.142,P=0.035).结论 成年男性胰岛素抵抗加重、胰岛素敏感性降低对BMD无明显影响,但会导致骨微结构破坏、骨脆性增加.
Objective To explore the correlation between insulin resistance and bone mineral density(BMD)and bone microstructure in adult males.Methods Chinese adult males who underwent examinations in the department of geriatric endocrinology of the First Affiliated Hospital with Nanjing Medical University from January 2018 to July 2021 were retrospectively selected as study subjects.The results of oral glucose tolerance tests,BMD,and trabecular bone score(TBS)were collected.Indices such as homeostasis model assessment of β-cell function(HOMA-β),homeostasis model assessment of insulin resistance(HOMA-IR),and the Matsuda index were calculated using a steady-state model.Multiple linear regression analysis was used to explore the correlation between metabolic-related indicators and BMD,TBS.Results A total of 283 adult males were included.Body mass index(BMI)(r=0.279,P<0.001),fasting insulin level(r=0.174,P=0.003),HOMA-IR(r=0.184,P=0.002)was all positively correlated with BMD,but the Matsuda index was negatively correlated with BMD(r=-0.157,P=0.008).Low-density lipoprotein cholesterol(r=-0.136,P=0.022),HOMA-β(r=-0.140,P=0.018),and HOMA-IR(r=-0.160,P=0.007)were negatively correlated with TBS,while the Matsuda index was positively correlated with TBS(r=0.156,P=0.009).Multiple linear regression analysis showed that after adjusting for age,BMI,and blood lipid indicators,while the correlation between HOMA-IR and Matsuda index with BMD disappeared(P>0.05);HOMA-IR was still negatively associated with TBS(β=-0.143,P=0.039),and Matsuda index was still positively associated with TBS(β=0.142,P=0.035).Conclusion The aggravation of insulin resistance and the decrease in insulin sensitivity are not related to changes in BMD,but can lead to bone microstructure destruction and increased bone fragility.
祁寒梅;程鹏;蔡金梅;赖兵;张爱森
南京医科大学第一附属医院老年内分泌科(南京 210029)南京医科大学第一附属医院老年内分泌科(南京 210029)南京医科大学第一附属医院老年内分泌科(南京 210029)南京医科大学第一附属医院老年内分泌科(南京 210029)南京医科大学第一附属医院老年内分泌科(南京 210029)
医药卫生
胰岛素抵抗骨密度骨微结构骨小梁分数
Insulin resistanceBone mineral densityBone microstructureTrabecular bone score
《医学新知》 2026 (6)
617-623,7
江苏省干部保健科研课题(BJ23002)
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