老年女性2型糖尿病患者睡眠障碍与骨质疏松症关系的初步研究
目的初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍组和睡眠障碍组，应用双能X线骨密度仪测量股骨颈、Wards三角区、大转子、腰椎L2～L4的骨密度值，将患者再分为无骨质疏松症组和骨质疏松症组。测定生化指标，行口服葡萄糖耐量试验（OGTT）及胰岛素、胰高糖素释放试验，比较两组骨密度值、空腹和糖负荷后胰岛仪和B细胞功能，对睡眠障碍和骨质疏松症行Logistic回归分析。结果（1）睡眠障碍组股骨颈、Wards三角区等骨密度值低于无睡眠障碍组ft=2．9652～6．3403，均P...
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| Published in | 中华糖尿病杂志 no. 1; pp. 15 - 21 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
300070天津医科大学代谢病医院内分泌研究所卫生部激素与发育重点实验室
2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.issn.1674-5809.2016.01.005 |
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| Abstract | 目的初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍组和睡眠障碍组，应用双能X线骨密度仪测量股骨颈、Wards三角区、大转子、腰椎L2～L4的骨密度值，将患者再分为无骨质疏松症组和骨质疏松症组。测定生化指标，行口服葡萄糖耐量试验（OGTT）及胰岛素、胰高糖素释放试验，比较两组骨密度值、空腹和糖负荷后胰岛仪和B细胞功能，对睡眠障碍和骨质疏松症行Logistic回归分析。结果（1）睡眠障碍组股骨颈、Wards三角区等骨密度值低于无睡眠障碍组ft=2．9652～6．3403，均P〈0，05），骨质疏松症患病率高于无睡眠障碍组f63．7％比47．7％，x2=13．891，P〈0．05）。睡眠障碍各亚组骨密度值均低于无睡眠障碍同亚组，大转子、L2和L3骨密度值降低明显（均P〈0．05）。（2）睡眠障碍组各时间点胰高糖素水平、胰高糖素曲线下面积和0、30、180rain胰高糖素／胰岛素比值以及胰高糖素／血糖比值明显高于无睡眠障碍组（t=1．0332～19．6437，均P〈0．05）。睡眠障碍组糖化血红蛋白（HbA1c）、果糖胺、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA．IR）均高于无睡眠障碍组[（8．0±1．9）％比（7．3±1．6）％，（0．32±0．10）比f0．30±0．08）mmol／L，（13±4）比（12±4）mU／L，4．7±0．8比3．8±0．8，t=4．5956、2．5445、2．9871、11．8356，均P〈0．051。睡眠障碍组胰岛素敏感指数为-4．2±0．5，低于无睡眠障碍组的-4．0±0．4（t=4．1559，P〈0．05）。与无睡眠障碍各亚组相比，睡眠障碍各亚组上述指标变化更明显（均P〈0．05）。（3）Logistic回归分析显示睡眠障碍与HOMA．IR、HbA。胰高糖素曲线下面积呈正相关（OR=2．452、1．119、1．223，均P〈0．05），而骨质疏松症与绝经年限、HbA1c,胰高糖素曲线下面积、睡眠障碍呈正相关（OR=20．677、19．948、23．445、23．682，均P〈0．05）。结论在老年女性2型糖尿病患者，睡眠障碍可能通过影响胰岛α和β细胞功能与骨质疏松症相关。 |
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| AbstractList | 目的：初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍组和睡眠障碍组，应用双能X线骨密度仪测量股骨颈、Wards三角区、大转子、腰椎L2～L4的骨密度值，将患者再分为无骨质疏松症组和骨质疏松症组。测定生化指标，行口服葡萄糖耐量试验（OGTT）及胰岛素、胰高糖素释放试验，比较两组骨密度值、空腹和糖负荷后胰岛α和β细胞功能，对睡眠障碍和骨质疏松症行Logistic回归分析。结果（1）睡眠障碍组股骨颈、Wards三角区等骨密度值低于无睡眠障碍组(t=2.9652~6.3403，均P<0.05)，骨质疏松症患病率高于无睡眠障碍组(63.7%比47.7%,χ2=13.891，P<0.05)。睡眠障碍各亚组骨密度值均低于无睡眠障碍同亚组，大转子、L2和L3骨密度值降低明显(均P<0.05)。（2）睡眠障碍组各时间点胰高糖素水平、胰高糖素曲线下面积和0、30、180 min胰高糖素/胰岛素比值以及胰高糖素/血糖比值明显高于无睡眠障碍组(t=1.0332～19.6437，均P<0.05)。睡眠障碍组糖化血红蛋白（HbA1c）、果糖胺、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA-IR）均高于无睡眠障碍组[(8.0±1.9)%比(7.3±1.6)%，(0.32±0.10)比(0.30±0.08)mmol/L，(13±4)比(12±4)mU/L，4.7±0.8比3.8±0.8，t=4.5956、2.5445、2.9871、11.8356，均P<0.05]。睡眠障碍组胰岛素敏感指数为-4.2±0.5，低于无睡眠障碍组的-4.0±0.4(t=4.1559，P<0.05)。与无睡眠障碍各亚组相比，睡眠障碍各亚组上述指标变化更明显(均P<0.05)。（3）Logistic回归分析显示睡眠障碍与HOMA-IR、HbA1c、胰高糖素曲线下面积呈正相关（OR=2.452、1.119、1.223，均P<0.05），而骨质疏松症与绝经年限、HbA1c、胰高糖素曲线下面积、睡眠障碍呈正相关（OR=20.677、19.948、23.445、23.682，均P<0.05）。结论在老年女性2型糖尿病患者，睡眠障碍可能通过影响胰岛α和β细胞功能与骨质疏松症相关。 目的初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍组和睡眠障碍组，应用双能X线骨密度仪测量股骨颈、Wards三角区、大转子、腰椎L2～L4的骨密度值，将患者再分为无骨质疏松症组和骨质疏松症组。测定生化指标，行口服葡萄糖耐量试验（OGTT）及胰岛素、胰高糖素释放试验，比较两组骨密度值、空腹和糖负荷后胰岛仪和B细胞功能，对睡眠障碍和骨质疏松症行Logistic回归分析。结果（1）睡眠障碍组股骨颈、Wards三角区等骨密度值低于无睡眠障碍组ft=2．9652～6．3403，均P〈0，05），骨质疏松症患病率高于无睡眠障碍组f63．7％比47．7％，x2=13．891，P〈0．05）。睡眠障碍各亚组骨密度值均低于无睡眠障碍同亚组，大转子、L2和L3骨密度值降低明显（均P〈0．05）。（2）睡眠障碍组各时间点胰高糖素水平、胰高糖素曲线下面积和0、30、180rain胰高糖素／胰岛素比值以及胰高糖素／血糖比值明显高于无睡眠障碍组（t=1．0332～19．6437，均P〈0．05）。睡眠障碍组糖化血红蛋白（HbA1c）、果糖胺、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA．IR）均高于无睡眠障碍组[（8．0±1．9）％比（7．3±1．6）％，（0．32±0．10）比f0．30±0．08）mmol／L，（13±4）比（12±4）mU／L，4．7±0．8比3．8±0．8，t=4．5956、2．5445、2．9871、11．8356，均P〈0．051。睡眠障碍组胰岛素敏感指数为-4．2±0．5，低于无睡眠障碍组的-4．0±0．4（t=4．1559，P〈0．05）。与无睡眠障碍各亚组相比，睡眠障碍各亚组上述指标变化更明显（均P〈0．05）。（3）Logistic回归分析显示睡眠障碍与HOMA．IR、HbA。胰高糖素曲线下面积呈正相关（OR=2．452、1．119、1．223，均P〈0．05），而骨质疏松症与绝经年限、HbA1c,胰高糖素曲线下面积、睡眠障碍呈正相关（OR=20．677、19．948、23．445、23．682，均P〈0．05）。结论在老年女性2型糖尿病患者，睡眠障碍可能通过影响胰岛α和β细胞功能与骨质疏松症相关。 |
| Abstract_FL | Objective To investigate the association between sleep disorder and osteoporosis in elderly female patients with type 2 diabetes. Methods Five hundred and thirty-six elderly female patients with type 2 diabetes aged above 60 years were recruited from July 2011 to July 2014. They were divided into two groups according to Pittsburgh Sleep Quality Index: patients without sleep disorder and patients with sleep disorder. The bone mineral density of femoral neck, Wards triangle, greater trochanter and lumbar spines(L2-L4) was measured by dual-energy X-ray absorptiometry. The groups were further divided into osteoporosis negative group and osteoporosis group. Biochemical indicators were detected in the two groups. Oral glucose tolerance test, insulin releasing test and glucagon releasing test were performed. We compared the differences of bone mineral density as well asα-cell andβ-cell function after fasting and glucose-load. The Logistic regression analysis was performed to analyze sleep disorder as well as osteoporosis and other indicators. Results (1)The bone mineral density of femoral neck, Wards triangle, greater trochanter and lumbar spines(L2-L4) was significantly lower(t=2.9652-6.3403, all P<0.05) and the prevalence of osteoporosis was significantly higher in patients with sleep disorder compared to those in patients without sleep disorder(χ2=13.891, P<0.05). Bone mineral density of sleep disorder subgroup was lower than those without sleep disorder, especially for greater trochanter and lumbar spines(L2-L3). (2) The level of glucagon at each time point and area under curve of glucagon as well as 0, 30, 180 min glucagon/insulin ratio and 0, 30, 60, 180 min glucagon/glucose ratio were significantly higher in patients with sleep disorder than those in patients without(t=1.0332-19.6437, all P<0.05). The levels of glycated hemoglobin A1c(HbA1c), fructosamine, fasting insulin, homeostasis model assessment of insulin resistance index (HOMA-IR) were significantly higher in patients with sleep disorder compared to those without sleep disorder ((8.0%±1.9%) vs (7.3%±1.6%), (0.32±0.10) vs (0.30±0.08)mmol/L, (13±4) vs (12±4)mU/L, (4.7±0.8) vs(3.8±0.8), t=4.5956, 2.5445, 2.9871, 11.8356, all P<0.05). Insulin sensitivity index was lower in patients with sleep disorder than that in patients without sleep disorder (-4.2±0.5 vs-4.0±0.4, t=4.1559, P<0.05). Significant changes of the above indicators were observed in sleep disorder subgroup compared to those without sleep disorder(all P<0.05). (3) Logistic regression analysis showed that sleep disorder was positively related to HOMA-IR, HbA1c and area under curve of glucagon(OR=2.452, 1.119, 1.223,all P<0.05),whereas osteoporosis was positively related to postmenopausal duration, HbA1c, area under curve of glucagon and sleep disorder(OR=20.677, 19.948, 23.445, 23.682,all P<0.05). Conclusions Sleep disorder may be associated with osteoporosis via influencing isletα-cell andβ-cell functions in elderly female patients with type 2 diabetes. |
| Author | 任惠珠 常宝成 郑妙艳 徐延光 杨菊红 王颖 杨艳辉 单春艳 |
| AuthorAffiliation | 天津医科大学代谢病医院内分泌研究所卫生部激素与发育重点实验室,300070 |
| AuthorAffiliation_xml | – name: 300070天津医科大学代谢病医院内分泌研究所卫生部激素与发育重点实验室 |
| Author_FL | Xu Yanguang Yang Yanhui Zheng Miaoyan Wang Ying Chang Baocheng Shan Chunyan Yang Juhong Ren Huizhu |
| Author_FL_xml | – sequence: 1 fullname: Ren Huizhu – sequence: 2 fullname: Chang Baocheng – sequence: 3 fullname: Zheng Miaoyan – sequence: 4 fullname: Xu Yanguang – sequence: 5 fullname: Yang Juhong – sequence: 6 fullname: Wang Ying – sequence: 7 fullname: Yang Yanhui – sequence: 8 fullname: Shan Chunyan |
| Author_xml | – sequence: 1 fullname: 任惠珠 常宝成 郑妙艳 徐延光 杨菊红 王颖 杨艳辉 单春艳 |
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| Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| DOI | 10.3760/cma.j.issn.1674-5809.2016.01.005 |
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| DocumentTitleAlternate | A preliminary study of association between sleep disorder and osteoporosis in elderly female patients with type 2 diabetes mellitus |
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| Keywords | Isletβ-cell Diabetes mellitus,type 2 Osteoporosis 胰岛α细胞 胰岛β细胞 睡眠障碍 Isletα-cell 糖尿病,2型 Sleep disorder 骨质疏松症 |
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| Notes | Ren Huizhu, Chang Baocheng, Zheng Miaoyan, Xu Yanguang, Yang Juhong, Wang Ying, Yang Yanhui, Shan Chunyan. （Key Laboratory of Hormones and Development （Ministry of Health）, Metabolic Disease Hospital ＆ Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300070, China） Diabetes mellitus, type 2; Sleep disorder; Osteoporosis; Islet α-cell; Islet β-cell 11-5791/R Objective To investigate the association between sleep disorder and osteoporosis in elderly female patients with type 2 diabetes. Methods Five hundred and thirty-six elderly female patients with type 2 diabetes aged above 60 years were recruited from July 2011 to July 2014. They were divided into two groups according to Pittsburgh Sleep Quality Index： patients without sleep disorder and patients with sleep disorder. The bone mineral density of femoral neck, Wards triangle, greater trochanter and lumbar spines（L2-IA） was measured by dual-energy X-ray absorptiometry. The groups were further divided into osteoporosis negative group and ost |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitleAlternate | CHINESE JOURNAL OF DIABETES MELLITUS |
| PublicationYear | 2016 |
| Publisher | 300070天津医科大学代谢病医院内分泌研究所卫生部激素与发育重点实验室 |
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| Snippet | 目的初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍组... 目的：初步研究老年女性2型糖尿病患者睡眠障碍与骨质疏松症的关系。方法2011年7月至2014年7月，将536例60岁以上的女性2型糖尿病患者，按匹兹堡睡眠质量指数分为无睡眠障碍... |
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| SubjectTerms | 睡眠障碍 糖尿病，2型 胰岛α细胞 胰岛β细胞 骨质疏松症 |
| Title | 老年女性2型糖尿病患者睡眠障碍与骨质疏松症关系的初步研究 |
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