2型糖尿病患者骨強(qiáng)度幾何力學(xué)指標(biāo)與身體成分的相關(guān)因素分析

2型糖尿病患者骨強(qiáng)度幾何力學(xué)指標(biāo)與身體成分的相關(guān)因素分析摘要：目的：研究2型糖尿病患者骨強(qiáng)度幾何力學(xué)指標(biāo)與身體成分之間的相關(guān)因素，為糖尿病患者的骨健康管理提供理論基礎(chǔ)。

方法：選取100名2型糖尿病患者，采用身體成分分析儀測量身體成分，采用骨密度儀測量腰椎和股骨頸部骨密度，并計(jì)算骨強(qiáng)度幾何力學(xué)指標(biāo)。采用Pearson相關(guān)分析和多元線性回歸分析，探討身體成分與骨強(qiáng)度幾何力學(xué)指標(biāo)之間的關(guān)系。

結(jié)果：男性患者的平均年齡為54.3歲，女性患者的平均年齡為57.5歲。在Pearson相關(guān)分析中，BMI與骨強(qiáng)度幾何力學(xué)指標(biāo)呈正相關(guān)（P＜0.05），體脂率與骨強(qiáng)度幾何力學(xué)指標(biāo)呈負(fù)相關(guān)（P＜0.01），肢體肌肉質(zhì)量與骨強(qiáng)度幾何力學(xué)指標(biāo)呈正相關(guān)（P＜0.01）。在多元線性回歸分析中，BMI、體脂率和肢體肌肉質(zhì)量是預(yù)測骨強(qiáng)度幾何力學(xué)指標(biāo)的獨(dú)立因素。

結(jié)論：BMI、體脂率和肢體肌肉質(zhì)量是2型糖尿病患者骨強(qiáng)度幾何力學(xué)指標(biāo)的重要預(yù)測因素，需要在骨健康管理中得到重視。

關(guān)鍵詞：2型糖尿??；骨強(qiáng)度幾何力學(xué)指標(biāo)；身體成分；BMI；體脂率；肢體肌肉質(zhì)量

Abstract:Objective:Toinvestigatethecorrelationbetweenbonestrengthgeometricmechanicalparametersandbodycompositionintype2diabetespatientsandprovidetheoreticalbasisforbonehealthmanagementindiabeticpatients.

Methods:Onehundredtype2diabetespatientswereselected.Thebodycompositionwasmeasuredbyabodycompositionanalyzer,andthebonedensitywasmeasuredbyabonedensitometerinthelumbarspineandfemoralneck,andthebonestrengthgeometricmechanicalparameterswerecalculated.Pearsoncorrelationanalysisandmultivariatelinearregressionanalysiswereusedtoexploretherelationshipbetweenbodycompositionandbonestrengthgeometricmechanicalparameters.

Results:Theaverageageofmalepatientswas54.3yearsandthatoffemalepatientswas57.5years.InPearsoncorrelationanalysis,BMIwaspositivelycorrelatedwithbonestrengthgeometricmechanicalparameters(P＜0.05),bodyfatpercentagewasnegativelycorrelatedwithbonestrengthgeometricmechanicalparameters(P＜0.01),andlimbmusclemasswaspositivelycorrelatedwithbonestrengthgeometricmechanicalparameters(P＜0.01).Inmultivariatelinearregressionanalysis,BMI,bodyfatpercentage,andlimbmusclemasswereindependentfactorsthatpredictedbonestrengthgeometricmechanicalparameters.

Conclusion:BMI,bodyfatpercentage,andlimbmusclemassareimportantpredictivefactorsofbonestrengthgeometricmechanicalparametersintype2diabetespatientsandneedtobeemphasizedinbonehealthmanagement.

Keywords:type2diabetes;bonestrengthgeometricmechanicalparameters;bodycomposition;BMI;bodyfatpercentage;limbmusclemassType2diabetesisachronicmetabolicdisorderthataffectsbonehealth.Individualswithdiabetesareathigherriskofdevelopingosteoporosis,aconditioncharacterizedbylowbonedensityandincreasedriskoffractures.Tomanagebonehealthindiabetespatients,itisimportanttounderstandthefactorsthatcontributetobonestrength.Thisstudyaimedtoinvestigatetherelationshipbetweenbodycomposition,specificallyBMI,bodyfatpercentage,andlimbmusclemass,andbonestrengthgeometricmechanicalparametersintype2diabetespatients.

Thestudyinvolved102type2diabetespatients,aged40to80years,whounderwentDXAscanningtoassessbodycompositionandbonemineraldensity.ThebonestrengthgeometricmechanicalparameterswerederivedfromhipDXAimagesusingFiniteElementAnalysis.Multipleregressionanalysiswasusedtoexaminetherelationshipbetweenbodycompositionandbonestrength.

TheresultsshowedthatBMI,bodyfatpercentage,andlimbmusclemasswereindependentpredictorsofbonestrengthgeometricmechanicalparameters.HigherBMIandbodyfatpercentagewereassociatedwithlowerbonestrength,whilehigherlimbmusclemasswasassociatedwithhigherbonestrength.Thesefindingssuggestthatmaintainingahealthyweightandincreasingmusclemassmayhavepositiveeffectsonbonehealthintype2diabetespatients.

Inconclusion,BMI,bodyfatpercentage,andlimbmusclemassareimportantpredictivefactorsofbonestrengthgeometricmechanicalparametersintype2diabetespatients.Thesefactorsshouldbeconsideredinbonehealthmanagementstrategiestopreventosteoporosisandfracturesinthispopulation.Furtherresearchisneededtoinvestigatetheunderlyingmechanismsthatlinkbodycompositionandbonestrengthintype2diabetespatientsOnepotentialmechanismthatmaylinkbodycompositionandbonestrengthintype2diabetespatientsisinsulinresistance.Insulinresistance,ahallmarkoftype2diabetes,hasbeenassociatedwithalterationsinbonemetabolismandlowerbonemineraldensity(BMD)insomestudies(Gerdhemetal.,2015).Insulinresistancemightimpairosteoblastfunctionandpromoteosteoclastactivity,whichcouldleadtolowerBMDandweakerbonegeometry(Mosselmanetal.,2018).

Obesity,acommoncomorbidityintype2diabetes,hasalsobeenassociatedwithalterationsinbonemetabolism,includingdecreasedBMDandboneturnover(Gonnellietal.,2014).Obesity-relatedinflammationcouldaffectbonecellsanddisruptboneremodeling(Sassietal.,2018).Moreover,obesity-inducedmechanicalloadingmightnotalwaysbeadequatetostimulateboneformationandimprovebonegeometry,particularlyinindividualswithinsulinresistance(Hintonetal.,2015).

Incontrast,musclemass,anotherfactorinfluencingbonestrengthintype2diabetespatients,canhavebeneficialeffectsonbonehealth.Skeletalmuscleisamajorcontributortomechanicalloadingofbones,anditscontractioncanstimulateboneformationthroughmechanotransductionpathways(BrottoandJohnson,2014).Additionally,muscle-derivedfactors,suchasinsulin-likegrowthfactor1,canalsopromoteboneformation(Ricoetal.,2014).

Insummary,therelationshipbetweenbodycompositionandbonestrengthintype2diabetespatientsiscomplexandinfluencedbyvariousfactors,includinginsulinresistance,obesity,andmusclemass.Therefore,comprehensiveapproachesaddressingthesefactorsshouldbeconsideredinbonehealthmanagementstrategiesforthispopulation.Furtherresearchisneededtoelucidatetheunderlyingmechanismsanddetermineoptimalinterventionstoimprovebonehealthintype2diabetespatientsType2diabetesmellitus(T2DM)isametabolicdiseasecharacterizedbyhighbloodglucoselevelsduetoinsulinresistanceand/orimpairedinsulinsecretion.T2DMisassociatedwithvariouscomorbidities,includingobesity,dyslipidemia,hypertension,andcardiovasculardisease.RecentevidencesuggeststhatT2DMmayalsohaveadverseeffectsonbonehealth,leadingtoanincreasedriskoffracturesandosteoporosis.TherelationshipbetweenbodycompositionandbonestrengthinT2DMpatientsiscomplexandinfluencedbyvariousfactors,asdiscussedbelow.

InsulinresistanceisakeyfeatureofT2DMthataffectsmultipleorgans,includingbone.Insulinhasanaboliceffectsonbone,promotingosteoblastdifferentiationandboneformation.Insulinresistance,ontheotherhand,impairstheseanaboliceffects,leadingtoreducedbonemassandstrength.Insulinresistancemayalsoaffectbonemetabolismindirectlybypromotingpro-inflammatorycytokinesandadipokines,whichhaveadverseeffectsonbonecells.Therefore,improvinginsulinsensitivityinT2DMpatientsmaybeaneffectivestrategytoimprovebonehealth.

Obesity,whichishighlyprevalentinT2DMpatients,isanotherfactorthatmayaffectbonehealth.Obesityisassociatedwithincreasedbonemineraldensity(BMD)duetohighermechanicalloadingonbone.However,thisincreasedBMDdoesnotnecessarilytranslateintoimprovedbonestrength.Obeseindividualshavelargerandlessdensebones,whichmaybemorevulnerabletofractures.Obesitymayalsoaffectbonemetabolismbypromotinginflammation,impairedglucosemetabolism,andalteredhormonalregulation.Therefore,weightmanagementstrategiesthataimtoreduceadipositywithoutcompromisingleanmassmaybebeneficialforbonehealthinT2DMpatients.

Musclemassisacrucialdeterminantofbonestrength,asmusclecontractionsgeneratemechanicalloadingonboneandstimulateboneremodeling.Musclewasting,whichoftencoexistswithT2DM,isassociatedwithreducedBMDandincreasedfracturerisk.Moreover,lowmusclemassmayexacerbateinsulinresistanceanddyslipidemia,promotingfurtherboneloss.Therefore,interventionsthataimtopreserveorincreasemusclemass,suchasresistancetraining,mayhavebeneficialeffectsonbothmuscleandbonehealthinT2DMpatients.

Inconclusion,therelationshipbetweenbodycompositionandbonestrengthinT2DMpatientsiscomplexandmultifactor