标题：老年2型糖尿病患者25(OH)D3、Hcy、SUA水平变化及其与骨代谢、骨密度及骨质疏松的相关性

      作者：葛迎晓，王华，许丹妮，蓝敏，茹倩影    上海交通大学医学院附属同仁医院老年科，上海 200336

      卷次： 2022年33卷11期

      【摘要】 目的 探讨老年2型糖尿病患者25羟基维生素D3 [25(OH)D3]、同型半胱氨酸(Hcy)、尿酸(SUA)水平变化及其与骨代谢、骨密度及骨质疏松的相关性。方法 回顾性分析2019年 1月至 2020年 7月上海交通大学医学院附属同仁医院收治的 100例老年 2型糖尿病患者的临床资料，根据骨质疏松诊断标准分组，其中T值≤-2.5为骨质疏松组 26例，-2.5。结果 骨质疏松组患者的血清25(OH)D3水平为(9.10±1.53) μg/L，明显低于骨量减少组的(14.85±1.65) μg/L和骨量正常组的(21.20±2.21) μg/L，骨量减少组患者的25(OH)D3水平明显低于骨量正常组，差异均具有统计学意义(P<0.05)；骨质疏松组患者的血清Hcy、SUA水平分别为(18.23±2.18) μmol/L、(365.23±31.42) μmol/L，明显高于骨量减少组的(11.52±1.67) μmol/L、(291.05±23.18) μmol/L和骨量正常组的(7.02±1.38) μmol/L、(232.82±27.04) μmol/L，骨量减少组患者的Hcy、SUA水平明显高于骨量正常组，差异均具有统计学意义(P<0.05)；骨质疏松组患者的β-CTX、PTH水平分别为(0.78±0.15) ng/mL、(11.38±2.05) pmol/L，明显高于骨量减少组的(0.57±0.09) ng/mL、(6.62±1.63) pmol/L和骨量正常组的(0.40±0.06) ng/mL、(3.85±0.87) pmol/L，骨量减少组患者β-CTX、PTH水平明显高于骨量正常组，差异均有统计学意义(P<0.05)；骨质疏松组患者的血清OC水平及腰椎L1~4骨密度、股骨颈骨密度、全髋骨密度、均值骨密度均明显低于骨量减少组、骨量正常组，且骨量减少组患者的上述各项指标明显低于骨量正常组，差异均有统计学意义(P<0.05)；经 Pearson相关性分析结果显示，血清 25(OH)D3与β-CTX、PTH均呈负相关(P<0.05)，与OC、均值骨密度呈正相关(P<0.05)，血清Hcy、SUA与β-CTX、PTH均呈正相关(P<0.05)，与OC、均值骨密度呈负相关(P<0.05)。结论 老年2型糖尿病患者25(OH)D3、Hcy、SUA水平变化与骨代谢、骨密度具有明显相关性，且与骨质疏松的发生密切相关。
      【关键词】 老年；2型糖尿病；25羟基维生素D3；同型半胱氨酸；尿酸；骨代谢；骨密度；骨质疏松
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2022）11—1379—04

Changes of 25(OH)D3, Hcy, and SUA levels in elderly patients with type 2 diabetes and their correlation with bonemetabolism, bone mineral density, and osteoporosis.
GE Ying-xiao, WANG Hua, XU Dan-ni, LAN Min, RU Qian-ying.Department of Geriatrics, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200336,CHINA
【Abstract】 Objective To investigate the changes of 25 hydroxyvitamin D3 [25(OH)D3], homocysteine (Hcy),serum uric acid (SUA) levels in elderly patients with type 2 diabetes mellitus and their correlation with bone metabo-lism, bone mineral density, and osteoporosis. Methods The clinical data of 100 elderly patients with type 2 diabetesmellitus admitted to Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019to July 2020 were retrospectively analyzed. According to the diagnostic criteria of osteoporosis, T value ≤-2.5 was re-garded as osteoporosis group in 26 cases, -2.5. Results The 25(OH)D3 level in osteoporosis group was (9.10±1.53) μg/L, which was signifi-cantly lower than (14.85±1.65) μg/L in bone mass loss group and (21.20±2.21) μg/L in normal bone mass group; thelevel in bone mass loss group was significantly lower than that in normal bone mass group; the differences were statisti-cally significant (P<0.05). The Hcy and SUA levels in osteoporosis group were (18.23±2.18) μmol/L and (365.23±