摘要
本文对４６例ＮＩＤＤＭ病人（男２５例，女２１例，年龄５１．５±７．５岁）和１６例与之相匹配的健康人测定了ＢＭＣ、ＢＭＤ，血清钙、磷、ＡＫＰ、血糖、ＦＲＭ和胰岛素，尿中钙、肌酐和Ｈｙｐ。结果显示ＮＩＤＤＭ患者不论男、女的ＢＭＣ、ＢＭＤ均显著低于正常对照组，血清钙、磷正常，提示ＮＩＤＤＭ的骨量降低可能不伴有骨软化，而以骨质疏松为特点。ＮＩＤＤＭ组的Ｕｃａ／Ｕｃｒ明显升高（０．２３±０．２１比０．１４±０．０８，Ｐ＜０．０５），并且与血糖和血清果糖胺浓度呈正相关（ｒ＝０．３２和０．４１，Ｐ＜０．０５），提示ＮＩＤＤＭ出现骨量降低与高尿钙有关，而且高血糖引起高尿糖状态所致渗透性利尿很可能是高尿钙的主要原因之一。因此，有效地控制高血糖，将减少尿中钙、磷的丢失并预防ＮＩＤＤＭ患者骨质疏松的发生。本研究还发现ＮＩＤＤＭ患者ＢＭＤ与ＦＢＧ无关（ｒ＝０．１９，Ｐ＞０．０５），与ＦＲＭ呈负相关（ｒ＝－０．２６，Ｐ＜０．０５），与ＩＮＳ呈正相关（ｒ＝０．２９，Ｐ＜０．０５），提示残余的ＩＮＳ分泌量和代谢控制的质量是影响ＮＩＤＤＭ患者骨量的主要因素。所以，本研究认为良好的糖尿病控制，特别是予以适量胰岛素，对ＮＩＤＤＭ患者骨质疏松确?
BMC and BMD, the serum levels of Ca, P, AKP, GLU, FRM and INS, the urinary levels of Ca, Cr and Hyp from 46 patients with NIDDM (made 25, female 21, age 51.5±7. 5yrs) and 46age-and sex-matched controls were measured. The results showed that the BMC and BMD from the diabetics, both males and females, reduced compared with those from the controls. The serum Ca and P were normal in both groups. These indicate that the decrease in BMC and BMD from the diabetics may result from osteoporosis rather than osteomalacia. Uca/Ucr in the diabetic group was significantly higher than that in the control (0.23±0. 21 vs 0. 14±0. 08, P<0. 05), and positively correlated with the concentrations of blood glucose and FRM (r=0. 32 and 0. 41, P<0.05), indicating that bone loss in diabetics relate to hypercalcinuria. Osmotic diuresis caused by hyperglycemia may be one of the major factors for hypercalcinuria. Good control of hyperglycemia, therefore, will decrease calcium and phosphorus loss from urine and prevent osteoporosis in the patients with NIDDM. The results, also, showed that the BMD from the diabetics had no correlation with the levels of BGs (r=0.19, P<0.05) , and had negative correlation with the levels of FRM (r=-0. 26, P<0. 05), positive correlation with the levels of FINS (r=0. 29, P<0. 05). The results indicate that the impaired ability of insulin secretion of β cells and poor control of hyperglycemia may be responsible for the bone mass loss, suggesting optimal diabetic control, especially adequate insulin administrition, is certainly beneficial for osteoporosis in patients with NIDDM.
出处
《中国骨质疏松杂志》
CAS
CSCD
1995年第2期114-116,100,共4页
Chinese Journal of Osteoporosis
