标题：超声表观积分背散射系数评价2型糖尿病跟骨骨质状况

      作者：徐铮 1，2，冒蓓 2，李雪峰 3，左晓勇 3，李冠武 3    1.上海市普陀区长寿街道社区卫生服务中心超声科，上海 200060；2.上海市闵行区莘庄社区卫生服务中心超声科，上海 201100；3.上海中医药大学附属岳阳中西医结合医院医学影像科，上海 200437

      卷次： 2021年32卷13期

      【摘要】 目的 评价超声背散射表观积分背散射系数(AIB)对2型糖尿病(T2DM)跟骨骨质状况的应用价值，并探讨AIB与胰岛素抵抗指数(IR)的相关性。方法 回顾性分析岳阳中西医结合医院2018年1月至2020年8月期间收治的40例T2DM患者(T2DM组)及30例健康人群(对照组)的临床资料，两组受试者均行骨密度扫描及跟骨超声背散射信号采集并计算AIB。测定血脂、胰岛素、糖化血红蛋白及空腹血糖，计算 IR。采用Pearson相关分析AIB与糖脂指标及 IR的相关性，采用多元逐步回归分析AIB的独立相关因素。结果 T2DM组与对照组受试者的腰椎和髋部骨密度比较差异均无统计学意义(P>0.05)；T2DM组患者在3.5 MHz、5.0 MHz频率下的AIB分别为-12.84±3.53、-13.00±3.77，明显低于对照组的-9.76±3.40、-9.86±3.38，差异均有统计学意义(P<0.05)；T2DM组患者AIB与体质量指数、低密度脂蛋白胆固、甘油三脂、空腹血糖、糖化血红蛋白及 IR存在相关性(P<0.05)，但与骨密度无相关性(P>0.05)；多元线性回归分析提示，IR及体质量指数是T2DM患者AIB的独立相关因素(P<0.05)。结论 跟骨超声AIB与 IR呈负相关，AIB可作为T2DM患者骨质状况评价的有效指标。
      【关键词】 2型糖尿病；超声；表观积分背散射系数；胰岛素抵抗指数
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2021）13—1713—03

Calcaneus bone strength assessment using ultrasonic apparent integrated backscatter coefficient in patients with type2 diabetes.
XU Zheng 1,2, MAO Bei 2, LI Xue-feng 3, ZUO Xiao-yong 3, LI Guan-wu 3. 1. Department of Ultrasound, ShanghaiPutuo District Changshou Community Health Service Center, Shanghai 200060, CHINA; 2. Department of Ultrasound, ShanghaiMinhang District Xinzhuang Community Health Service Center, Shanghai 201100, CHINA; 3. Department of Imaging, YueyangIntegrated Traditional Chinese and Western Medicine Hospital, Shanghai University of TCM, Shanghai 200437, CHINA
【Abstract】 Objective To explore the value of ultrasonic apparent integrated backscatter coefficient (AIB) forassessing calcaneus bone strength in patients with type 2 diabetes mellitus (T2DM) and to determine its correlation withinsulin resistance (IR). Methods We retrospectively analyzed 40 T2DM patients and 30 healthy controls in Yueyang In-tegrated Traditional Chinese and Western Medicine Hospital between January 2018 and August 2020, who underwentAIB measurements and bone density examinations. Fasting blood glucose, insulin, glycosylated hemoglobin (HbA1c),and blood lipid levels were measured, and IR was calculated. Pearson correlation analysis was used to analyze the rela-tionships of AIB with glycolipid indexes and IR, and multiple stepwise regression analysis was used to analyze indepen-dent factors of AIB. Results Compared with the controls, there was no statistically significant difference in lumbarspine and hip bone density in T2DM group. AIB at 3.5 MHz and 5.0 MHz of the T2DM group were -12.84 ± 3.53and -13.00±3.77, respectively, which were significantly lower than -9.76±3.40 and -9.86±3.38 of the controls (P<0.05).In T2DM group, AIB was correlated with body mass index, low-density lipoprotein, triglycerides, fasting blood glucose,HbA1c, and IR (P<0.05), but was not related with bone density (P>0.05). IR and body mass index were independent fac-tors of AIB in T2DM patients. Conclusion Calcaneus ultrasonic AIB negatively correlated with IR. AIB could assessskeletal integrity for T2DM patients.
      【Key words】 Type 2 diabetes; Ultrasound; Apparent integral backscatter coefficient; Insulin resistance index