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2형 당뇨병이 있는 50세 이상 남성 및 폐경후여성에서의 골밀도

Bone mineral density in type 2 diabetic patients aged 50 years or older in men and postmenopausal women in Korea

정동진|조정란
한국컴퓨터정보학회 (The Korean Society Of Computer And Information)|2021.08|한국컴퓨터정보학회논문지 (Journal of The Korea Society of Computer and Information)|제26권 제8호|pp. 197-207|DOI https://doi.org/10.9708/jksci.2021.26.08.197

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키워드

국민건강영양조사당뇨병KNHANES골다공증diabetes골밀도fracturebone mineral densityosteoporosis골절
주제분류컴퓨터학

초록

2형 당뇨병환자에서 골밀도는 다양하게 보고되고 있다. 최근의 여러 역학조사 연구에 의하면 2형당뇨병 환자에서 골밀도 상태와 무관하게 골절 위험이 증가한다는 보고들이 많다. 본 연구에서는 전국민을 대상으로 한 표본조사로부터 얻은 질병관리본부의 국민건강영양조사 2008-2011년 자료를 이용하여 2형 당뇨병이 있는 50세 이상 남성 및 폐경후여성에서 골밀도를 확인하고자 하였다. 골다공증약물을 사용한 경우 및 당뇨병 이외에 골밀도에 영향을 미치는 질환 및 악성질환 등이 있는 대상은 제외하였다. 신체계측, 설문조사, 혈액검사 등과 함께 이중에너지흡수방사선을 이용하여 요추 및 대퇴골에서측정한 골밀도 결과를 이용하였다. 연령, 체질량지수, 월 가구수입, 교육수준, 신체활동, 1일 칼슘섭취량, 혈중 비타민 D 농도를 포함하는 다중회귀분석을 시행한 결과 2형 당뇨병이 있는 50세 이상 남성및 폐경후여성 모두에서 당뇨병이 없는 군과 비교하여 요추골밀도가 유의하게 높게 나타났다.

Abstract

Relationship between bone mineral density (BMD) and type 2 diabetes is still inconsistent. Recently, many epidemiologic data show that fracture risk is increased in type 2 diabetic patients regardless of BMD status. In this study, we used nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) to analyze the BMD status in patients with type 2 diabetes compared to non-diabetics. We included subjects aged 50 years or older in men (N=2,959, 2,430 without diabetes, 529 with type 2 diabetes) and postmenopausal women (N=2,902, 2,479 without diabetes, 423 with type 2 diabetes). Subjects with history of medication for osteoporosis or with illness or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Serum was separated from peripheral venous blood samples obtained after 8 hours of fasting. BMD was measured at lumbar spine and femur using dual-energy X-ray absorptiometry (DXA). There was a significant positive association between lumbar spine BMD and type 2 diabetes after adjusting age, gender, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration by multiple regression analysis in all subjects. In the subgroup analysis by gender, this association was maintained both in male and female after adjusting those confounding factors. However, femur BMD was not different between type 2 diabetic and non-diabetic subjects. In conclusion, lumbar spine BMD was significantly higher in type 2 diabetic patients aged 50 years or more in men and postmenopausal women compared to non-diabetic subjects.

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