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JCEM:胰岛素抵抗对老年人骨密度和骨折风险的影响

2019-03-01 xing.T 网络

由此可见,非糖尿病老年人更大的IR与BMD升高有关。与T2D和骨折风险之间的关系相反,该研究没有找到一致的证据表明,在调整BMI和BMD后,更大的IR与骨折风险增加有关。

尽管具有较高的骨矿物质密度(BMD),但与非糖尿病患者相比,2型糖尿病(T2D)成年患者具有更高的骨折风险。胰岛素抵抗(IR)与BMD增加有关。然而,目前尚不清楚IR是否会增加骨折风险。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在探究非糖尿病患者IR(HOMA-IR)、BMD与非脊柱骨折之间的关系。

参与者包含了2398名社区居住的非糖尿病老年人(年龄为74±3岁,53%为女性,38%为黑人),他们同时参与了健康、老龄和身体成分的前瞻性队列研究(中位随访:12[四分位数间距为6] 年)。

HOMA-IR四分位数的截止值分别为1.05、1.54和2.33。HOMA-IR处于在第1个四分位数的个体与第4个四分位数个体相比,总髋BMD高出0.104g/cm2(p<0.001)。调整BMI后,该差异减弱(调整后的平均差为0.007g/cm 2; p=0.371)。在未调整的模型中,HOMA-IR较高的个体骨折风险较低(HOMA-IR处于第3和第4个四分位数的个体与第1个四分位数的个体相比,风险比[HR]分别为0.86[95%CI为0.73-1.01]和0.65[95%CI为0.47-0.89])。然而,在调整BMD和BMI后,与第1个四分位数相比,第3个四分位数个体的骨折风险显著增高(HR为1.19,95%CI为1.00-1.41),并且在第4个四分位数中趋于增加(HR为1.12,95%CI为0.87-1.46)。

由此可见,非糖尿病老年人更大的IR与BMD升高有关。与T2D和骨折风险之间的关系相反,该研究没有找到一致的证据表明,在调整BMI和BMD后,更大的IR与骨折风险增加有关。

原始出处:

Nicola Napoli.et al.Effect of Insulin Resistance on BMD and Fracture Risk in Older Adults.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2018-02539

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    2019-08-16 baoya
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    2019-09-28 smallant2015
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    2019-05-10 achengzhao
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