骨矿物质密度与心血管疾病和2型糖尿病患者死亡率的关联:基于人口的回顾性队列
Ran Chen1,2, Qingshan Guo1, Chuanqing Bai3
1War Trauma Medical Center, State Key Laboratory of Trauma and Chemical Poisoning, Daping Hospital, Army Medical Center, Army Medical University, Chongqing, 400042, P. R. China.
Diabetology & metabolic syndrome
|August 27, 2025
概括
在2型糖尿病 (T2D) 和非2型糖尿病 (NT2D) 患者中,低骨矿物质密度 (BMD) 会增加心血管疾病 (CVD) 的风险. 然而,高骨质量可能会增加T2D患者的心血管疾病风险,特别是男性,老年人,白人和肥胖患者.
科学领域:
- 内分泌学
- 心脏病学
- 老年学
背景情况:
- 2型糖尿病 (T2D) 复杂化了骨代谢,但T2D患者通常具有正常或高的骨矿物密度 (BMD).
- 这种悖论使得了解骨质疏松和心血管疾病 (CVD) 风险之间的关系变得复杂.
- 澄清这些关联对于风险分层和管理至关重要.
研究的目的:
- 调查部骨质量与心血管疾病和死亡风险之间的关联.
- 在患有T2D和没有T2D的人群中比较这些关联.
- 探索潜在的非线性关系,并确定T2D群体中存在差异性风险的子组.
主要方法:
- 一个回顾性队列研究,利用国家健康和营养检查调查 (2005-2018) 的数据.
- 参与者被分为T2D和非2型糖尿病 (NT2D) 组,并根据部骨质量水平 (T1,T2,T3) 进行进一步分层.
- 用权重的多变量分析和受限制的立方脊柱模型来评估骨和心血管疾病/死亡率之间的关联和非线性.
主要成果:
- 在NT2D和T2D组中,较低的骨质量与心血管疾病风险增加有关,而较高的骨质量通常具有保护作用.
- 然而,增加的骨质量 (T3) 与T2D男性,60岁以上的男性,白人男性和肥胖男性的心血管疾病风险增加有关.
- 在低 (T1) 和高 (T3) BMD水平下,T2D患者的心血管疾病死亡风险增加,在心血管疾病死亡风险与骨疾病之间观察到明显的J形 (NT2D) 和U形 (T2D) 非线性模式.
结论:
- 低骨质量是NT2D和T2D群体中心血管疾病和死亡率的重要危险因素.
- 相反,高骨质量可能代表特定T2D亚组的心血管风险升高,突出显示了复杂的相互作用.
- 这些发现强调需要在T2D管理中对骨硬化进行细致的风险评估.
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