摘要
目的 观察 DM患者骨密度 (bone mineral density,BMD)及其相关激素的改变 ,并探讨其发生机制。方法 采用双能 (线吸收法测量 2型 DM患者 6 8例、1型 DM患者 5 4例和健康人 6 2例的 BMD,放免法测定血清骨钙素、降钙素和 2 5羟维生素 D3,免疫放射法测定血清完整甲状旁腺素及 I型胶原羧基末段前肽。结果 1两组 DM患者全血Hb A1c水平均显著高于对照组 (P<0 .0 1) ,血清骨钙素水平显著低于对照组 (P<0 .0 1) ;2 2型 DM组 BMI、大转子BMD显著高于对照组和 1型 DM组 (BMI,P<0 .0 1;BMD,P<0 .0 5 ) ;1型 DM组股骨颈 BMD低于对照组和 2型 DM组 (P<0 .0 5 ) ,经 BMI纠正后 ,1型 DM组股骨颈 BMD仍低于对照组 (P<0 .0 5 ) ;31型 DM组各位点 BMD与血清 I型胶原羧基末段前肽水平呈负相关 (P<0 .0 5 ) ,2型 DM组腰椎和大转子 BMD与全血 Hb A1c水平呈负相关 (P<0 .0 5 )。结论 与健康人群相比 ,1型 DM患者 BMD明显降低 ,2型 DM患者 BMD明显增高 ,但经 BMI纠正后 ,这种差异性消失 ;
Objective To investigate the effect of diabetes mellitus on bone mineral density(BMD) and the related hormones and its pathogenesis in the patients with diabetes mellitus.Methods The subjects included 68 type 2 diabetic patients,54 type 1 diabetic patients and 62 normal controls. BMD was measured by dual energy x ray absorptiometry.The serum levels of osteocalcin,calcitonin and 25 hydroxyvitamin D were determined by radioimmunoassay. The serum levels of parathyroid hormone and collagen type 1 C terminal propeptide were determined by immunoradiometry. Results Compared with the control group, the blood level of HbA1c was significantly higher,but The serum level of osteocalcin was significantly lower in diabetic group( P <0.01). Body mass index (BMI) was significantly higher in subjects with type 2 diabetes compared with type 1 diabetes and control group( P <0.01).BMD was significantly higher at the great trochanter in subjects with type 2 diabetes compared with type 1 diabetes and control group( P <0.05),but after correction with BMI, there was no difference among the three groups. BMD was lower at the feroral neck in subjects with type 1 diabetes compared with type 2 diabetes and control group( P <0.05), after correction with BMI, BMD was still lower at the feroral neck in subjects with type 1 diabetes than control group( P <0.05);In type 1 diabetes mellitus, the change in BMD of all four sites correlates negatively with CICP(P(0.05),while the change in BMD at the lumbar spine and the great trochanter correlate negatively with HbA1c in type 2 diabetes mellitus( P <0.05).Conclusion Compared with control group, the subjects with type 1 diabetes mellitus have lower BMD,while the subjects with type 2 diabetes mellitus have higher BMD, but after correction with BMI, there was no difference among the three groups.The reduction of bone turnover and the degree of metabolic control of diabetes may contribute to the pathogenesis of diabetic osteoporosis.
出处
《中国糖尿病杂志》
CAS
CSCD
2002年第1期28-31,共4页
Chinese Journal of Diabetes
关键词
相关激素
影响
糖尿病
骨密度
骨代谢
Diabetes mellitus Bone mineral density Bone metalolism
