Abstract:【Objective】To analyze the sleep disorder and its influencing factors in elderly patients with type 2 diabetes mellitus (T2DM) and osteoporosis (OP). 【Methods】A total of 136 elderly patients with T2DM and OP from January 2016 to February 2018 were enrolled for the study as OP group. 150 elderly T2DM patients without OP were randomly selected as non-OP group and 100 healthy elderly during the same period were randomly selected as control group. The score of Pittsburgh Sleep Inventory Index (PSQI) were compared among three groups, and the relationship between clinical data and sleep disorder were analyzed in the three groups. 【Results】The scores and total scores of PSQI in the OP group and the NOP group were significantly higher than those in the CN group. The scores and total scores of subjective sleep disorder, sleep quality and sleep efficiency in the OP group were significantly higher than those in the NOP group (P<0.05). The incidence of sleep disorder in the OP group was 74.3% (101/136), significantly higher than that in the NOP group and the CN group (60.7%,35.0%) (P<0.05). In the OP group, the incidence of sleep disorders in patients with age ≤70 years, divorce or widowhood, duration of T2DM > 15 years, HbA1c > 9.0%, diabetic neuropathy, insulin use, pain sites (≥3), moderate and severe pain, muscle spasm, spinal deformity, severe OP and other patients increased significantly, while the incidence of sleep disorders in patients treated with anti-OP decreased significantly (P<0.05). Multivariate logistic regression analysis showed that the duration of T2DM>15 years, HbA1c > 9.0%, moderate to severe pain and severe OP were independent risk factors for sleep disorders (P<0.05). 【Conclusion】The sleep status of elderly patients with T2DM and OP is poor, about 3/4 of them have sleep disorders. The duration of T2DM>15 years, HbA1c>9.0%, moderate and severe pain and severe OP are independent risk factors for sleep disorders in elderly patients with T2DM and OP.
张红敏, 杨媚, 唐颖, 刘勋, 周唯妮, 张兴渝, 乐曦. 老年2型糖尿病伴骨质疏松患者的睡眠质量及其影响因素[J]. 医学临床研究, 2019, 36(3): 426-429.
ZHANG Hong-min, YANG Mei, TANG Ying, et al. Analysis of Sleep Quality and its Influencing Factors in Elderly Patients with Type 2 Diabetes Mellitus and Osteoporosis. JOURNAL OF CLINICAL RESEARCH, 2019, 36(3): 426-429.
[1] Guariguata L, Whiting D, Hambleton I,et al. Global estimates of diabetes prevalence for 2013 and projections for 2035[J].Diabetes Res Clin Pract,2014, 103(2): 137-149. [2] 韦瑛瑛,刘潇,俞柳萍,等.65岁以上2型糖尿病患者的诊治及预防[J].转化医学电子杂志,2016,3(7):94-95. [3] 房晓鹏,孙传伟,刘萍,等.不同方法血糖监测在70岁以上2型糖尿病患者中的应用价值对比[J].转化医学电子杂志,2015,31(7):35-35,37. [4] 李宝新,周雪,梁璇璇,等.老年男性2型糖尿病合并抑郁患者骨代谢指标与骨密度变化[J].中国医学前沿杂志(电子版),2015,7(12):17-20. [5] 周伶俐,潘玉荣,刘丽娜,等.老年女性2型糖尿病睡眠障碍与骨质疏松相关性研究[J].糖尿病新世界,2017,20(10):43-44. [6] 钱荣立.关于糖尿病新诊断标准与分型的意义[J].临床内科杂志,2000,17(3):133. [7] 路桃影,李艳, 夏萍,等. 匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263. [8] 叶兆莲,张龙英,王云,等.海南省人民医院健康体检人群骨质疏松状况及其相关影响因素分析[J].中国医学前沿杂志(电子版),2017,9(6):51-54. [9] 任惠珠,常宝成,单春艳,等.老年男性2型糖尿病患者睡眠障碍与骨质疏松的关系[J].中华老年医学杂志,2015,34(5):512-517. [10] 金启辉,陈怀红,禹华良,等.睡眠质量与老年2型糖尿病患者血糖及并发症的相关性[J].中华内科杂志,2012,51(5):357-361. [11] Rod NH, Vahtera J, Westerlund H, et al. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study [J].Am J Epidemiol,2011, 173(3):300-309. [12] Chasens ER, Korytkowski M, Sereika SM, et al.Effect of poor sleep quality and excessive daytime sleepiness on factors associated with diabetes self-management [J].Diabetes Educ,2012,39(1): 74-82. [13] Tsai YW, Kann NH, Tung TH, et al.Impact of subjective sleep quality on glycemic control in type 2 diabetes mellitus [J].Fam Pract,2012, 29(1): 30-35. [14] 宋志雪.老年骨质疏松患者睡眠障碍的影响因素与干预研究[D].华北理工大学,2016.