2型糖尿病发生骨质疏松与NLR、RDW、MPV、UA、TBIL相关性研究

Relationship between levels of NLR,RDW,MPV,UA,TBIL and osteoporosis in patients with type 2 diabetes

关键词:  2型糖尿病  骨质疏松  中性粒细胞/淋巴细胞  红细胞分布宽度  血小板平均分布宽度  尿酸  总胆红素

Key words:  diabetes mellitus  osteoporosis  neutrophil-lymphocyte ratio  red cell distribution width  mean platelet volume  uric acid  total bilirubin

摘要:

目的 探讨2型糖尿病患者发生骨质疏松与外周血中中性粒细胞/淋巴细胞（NLR）、红细胞分布宽度（RDW）、血小板平均分布宽度（MPV）、尿酸（UA）、总胆红素（TBIL）水平的相关性。方法 选取380例2型糖尿病患者进行骨密度（DEXA）检测，采用腰椎和左髋部两个部位的骨密度值，分为骨量正常组（n=91）、骨量减少组（n=140）以及骨质疏松症组（n=149），记录性别、年龄、身高、体重、收缩压、舒张压、糖尿病病程等相关资料，测量空腹血糖（FBG）、糖化血红蛋白（HbAlc）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、NLR、RDW、MPV、UA、TBIL等指标水平，比较三组间的差异并进行相关性分析。结果 年龄、性别、BMI、NLR、RDW、MPV、UA、TBIL在三组间均存在统计学差异（P<0.05），其中年龄、性别、NLR、RDW、MPV、UA与骨质疏松呈正相关，BMI、TBIL与骨质疏松呈负相关，多元Ordinal回归分析显示，年龄、NLR、UA为骨质疏松的危险因素（OR=2.208，1.013，P<0.05），相比于男性，女性发生骨质疏松的风险性更大，同样为其危险因素；BMI、TBIL为骨质疏松的保护性因素（OR=0.470，0.420，P<0.05）。结论 年龄、女性、NLR、UA为骨质疏松的危险因素，BMI、TBIL为骨质疏松的保护性因素。

Abstract:

Objective To investigate the relationship between levels of NLR,RDW,MPV,UA,TBIL and osteoporosis in patients with type 2 diabetes mellitus (T2DM). Methods A total of 380 T2DM patients underwent dual-energy X-ray absorptiometry (DEXA) to test the bone mineral density (BMD), including lumbar spine and left hip. According to the results, these patients were divided into 3 groups: normal bone mass group (n=91), osteopenia group (n=140) and osteoporosis group (n=149). The parameters such as gender, age, height, weight, systolic pressure, diastolic pressure, duration of T2DM, body mass index (BMI), etc. were collected. Serum levels of FBG, HbAlc, TG, TC, HDL-C, LDL-C, NLR, RDW, MPV, UA, TBIL were measured. The data with normal distribution was expressed by mean±SD. χ² test was used for count data analysis, liner correlation analysis for two variables, and ordinal regression for multi-factor analysis. P<0.05 was considered to be statistically significant. Results There were significant differences among the three groups in gender, age, BMI, NLR, RDW, MPV, UA, and TBIL (P<0.05). Among them, the age, gender, NLR, RDW, MPV and UA were positively correlated, whereas BMI and TBIL were negatively correlated with osteoporosis. Ordinal regression analysis revealed that age, NLR and UA were risk factors for osteoporosis (OR=2.208,1.013,P<0.05). Compared with men, women had a higher risk of osteoporosis and was also considered as a risk factor. BMI and TBIL were considered as protective factors of osteoporosis(OR=0.470,0.420,P<0.05). Conclusion Age, female, NLR, UA are regarded as risk factors of osteoporosis. BMI, TBIL are regarded as protective factors of osteoporosis.