| 钟海清,梁敏.2型糖尿病肾病患者骨密度水平的影响因素分析.[J].中南医学科学杂志.,2023,(1):49-52. |
| 2型糖尿病肾病患者骨密度水平的影响因素分析 |
| Analysis of influencing factors of bone mineral density in type 2 diabetic nephropathy patients |
| 投稿时间：2022-06-02 修订日期：2022-12-05 |
| DOI：10.15972/j.cnki.43-1509/r.2023.01.012 |
| 中文关键词: 慢性肾脏病 2型糖尿病肾病 骨密度 [ |
| 英文关键词:chronic kidney disease type 2 diabetic nephropathy bone mineral density |
| 基金项目:国家自然科学基金项目(81760165) |
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| 中文摘要: |
| 目的探讨2型糖尿病肾病患者骨密度(BMD)水平的影响因素。 方法收集未行透析的2型糖尿病肾病患者355例,根据KDOQI指南分期标准将其分为CKD1期、CKD2期、CKD3a-3b期、CKD4-5期4个组。比较各组生化指标和BMD水平,并进行影响因素分析。 结果随着CKD分期进展患者尿酸、血磷逐渐上升,血红蛋白、肌肝清除率、肾小球滤过率、股骨颈BMD逐渐下降(P＜0.05)；与CKD1-3期组比较,CKD4-5期组血钙、25-羟维生素D3下降,甲状旁腺激素、血镁升高(P＜0.05)。多元线性回归分析发现,女性、病程长是腰椎整体BMD下降的危险因素,高体质指数(BMI)是腰椎整体骨密度的保护因素；女性、高龄是股骨颈骨密度下降的危险因素,高BMI、高肌酐清除率是股骨颈骨密度的保护因素；女性是髋部整体骨密度下降的危险因素,高BMI、高肌酐清除率、高尿酸是髋部整体骨密度的保护因素。 结论女性是2型糖尿病肾病患者腰椎整体、股骨颈、髋部整体3个部位共同的骨密度下降危险因素,高BMI是3个部位共同的骨密度保护因素。 |
| 英文摘要: |
| AimTo explore the influencing factors of bone mineral density (BMD) in patients with type 2 diabetes nephropathy. MethodsA total of 355 patients with type 2 diabetic nephrotic disease who did not receive dialysis were collected and divided into 4 groups according to the KDOQI guidelines:CKD1 stage, CKD2 stage, CKD3a-3b stage and CKD4-5 stage. Biochemical indexes and bone mineral density were compared in each group, and the influencing factors were analyzed. ResultsWith the progression of CKD stage,, uric acid and blood phosphorus gradually increased, hemoglobin and femoral neck bone mineral density gradually decreased (P＜0.05); Compared with CKD1-3 group, serum calcium and 25 hydroxyvitamin D3 decreased, parathyroid hormone and blood magnesium increased in CKD4-5 group (P＜0.05). Multivariate linear regression analysis showed that women and long course of disease were the risk factors for the decline of lumbar BMD, and high body mass index (BMI) was the protective factor of lumbar BMD; Female and old age are the risk factors for the decline of femoral neck BMD, while high BMI and high creatinine clearance rate are the protective factors for femoral neck BMD; Women are the risk factors for the decline of hip bone mineral density. High BMI, high creatinine clearance rate and high uric acid are the protective factors of hip BMD. ConclusionWomen are the common risk factors of bone mineral density decline in the lumbar spine, femoral neck and hip of type 2 diabetes nephropathy patients, and high BMI is the common protective factor of bone mineral density in the three parts. |
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