摘要
目的探讨２型糖尿病患者骨密度（ＢＭＤ）改变及其机制。方法测定９３例２型糖尿病患者及９０例年龄、体重指数相匹配的健康对照者股骨近端（Ｎｅｃｋ、Ｔｒｏｃｈ、Ｗａｒｄ三角）及正位腰椎（Ｌ２Ｌ４）ＢＭＤ，血钙（Ｃａ）、磷（Ｐ）、甲状旁腺激素（ＰＴＨ）、尿ＣｒｏｓｓＬａｐ／Ｃｒ浓度。结果２型糖尿病患者股骨近端Ｎｅｃｋ、Ｔｒｏｃｈ、Ｗａｒｄ三角、Ｌ４、Ｌ２Ｌ４骨密度（ＢＭＤ）比对照组高；Ｌ２低于对照组。上述各部位（除外Ｌ２）ＢＭＤ糖尿病５年以下组（ＤＭＡ）组高于对照组，糖尿病５年及以上组（ＤＭＢ）组低于ＤＭＡ组，ＤＭＢ组Ｎｅｃｋ、Ｔｒｏｃｈ、Ｌ３、Ｌ４、Ｌ２Ｌ４部位ＢＭＤ低于对照组。Ｌ２部位ＢＭＤ：在ＤＭＡ组低于对照组，而在ＤＭＢ组高于ＤＭＡ组。将病程与ＢＭＤ进行相关性分析后显示：病程与股骨近端Ｎｅｃｋ、Ｗａｒｄ三角区ＢＭＤ呈显著负相关（Ｐ＜０．０５）。２型糖尿病组血Ｃａ、Ｐ浓度与对照组无显著差异；血骨钙素（ＢＧＰ）浓度显著低于对照组（Ｐ＜０．０５）；血ＰＴＨ浓度显著高于对照组（Ｐ＜０．０５）；尿Ｃｒｏｓｓｌａｐｓ／Ｃｒ比对照组高１４％，但差异无显著意义（Ｐ＞０．０５）。结论２型糖尿病患者各部位ＢＭ?
Objective To investigate into the change in bone mineral density (BMD) and its pathophysiology in patients with type 2 diabetes mellitus (DM). Methods BMD of proximal femur and AP spine and several metabolic parameters in 93 type 2 diabetes mellitus patients, were measured, and were compared with an age and BMI matched control group. Results ①type 2 diabetes mellitus patients had higher BMD at femoral neck、troch、Ward's triangle, L 4 and L 2 L 4 and had lower BMD at L 2 as compared with normal controls. ②Over all areas studied except L 2, DM A group had higher BMD than normal controls, DM B group had lower BMD than DM A group (DM course less than 5 years). At femoral neck,troch,L 3,L 4 and L 2 L 4 DM B group (DM course at least 5 years) had lower BMD than normal controls. At L 2, DM A group had lower BMD than normal controls, and DM B group had higher BMD than DM A group. ③In type 2 diabetes mellitus group, the duration of type 2 diabetes mellitus correlated negatively with BMD at femoral neck, troch and Ward's triangle (P<0.05). ④In type 2 diabetes mellitus patients serum Ca and P were normal. Serum parathyroid hormone was significantly higher than that of the controls (P<0.05). Serum bone glaprotein was significantly lower than that of the controls (P<0.05). Urine Crosslaps/Cr was higher than that of the controls, but without statistical significance. Conclusion The changes in BMD of above areas in type 2 diabetes mellitus patients are different and BMD of proximal femur correlates negatively with the duration of type 2 diabetes mellitus. The characteristics of bone change in type2diabetesmellituspatientshavehigh bone absorption rate and low bone turnover rate. Secondary hyperparathyroidism may probably contribute to the bone change.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
1999年第1期23-26,共4页
Chinese Journal of Endocrinology and Metabolism
关键词
糖尿病
骨密度
骨钙素
Ⅱ型
BMD
Diabetes mellitus, type 2 Bone mineral density Bone glaprotein
