摘要
目的探讨2型糖尿病患者骨代谢某些生化指标变化与胰岛素抵抗的关系,以了解其可能的发病机理。方法 测定60例2型糖尿病患者及50例年龄、性别、体重指数(BMJ)相匹配的健康对照者空腹血钙(Ca)、磷(P)、碱性磷酸酶(ALP)、糖(FBG)、骨钙素(BGP)、胰岛素(FINS)尿Ca/肌酐(Cr)的水平,并以BMI≥25kg/m^2为界将每组再分为肥胖和非肥胖两个亚组,用稳态模式胰岛素抵抗指数(HOMA-IR)计算胰岛素抵抗(IR=FBG×FINS/22.5)、胰岛素敏感指数(IAI=1/FBG×FINS)、胰岛素分泌指数(IS=FINS/FBG)。结果2型糖尿病组的BGP显著低于健康对照组(P<0.01),非肥胖组明显低于肥胖组(P<0.01),且糖尿病早期(5年内)就有明显下降(P<0.01),随病程的延长,BGP呈下降趋势,但无统计学意义(P>0.05);2型糖尿病组的尿Ca/Cr明显高于对照组(P<0.05)、其IR明显增高、IAI明显降低(P<0.01),IS虽有下降,但无统计学意义(P>0.05);在糖尿病的两亚组之间IR、IAI、IS差异均有显著意义(P<0.05);经相关系数分析,BGP与IS正相关,在非肥胖组与FBG负相关。结论2型糖尿病可引起骨代谢异常,在病程早期就已有骨代谢生化指标的变化,与胰岛素分泌及作用不足相关,肥胖和胰岛素抵抗所致糖代谢异常为其重要原因。
Objective To study the relationship betweet metabolism of bone and insulin resistance (IR) and its pathogenesis in the patients with type 2 diabetes mellitus. Methods Detected 60 type 2 diabetes patients and 50 healthy men whose age 、 sexual distinction and body mass index (BMI) were matched each other,observed their calcium( Ca) ,phosphor( P) , alkaline phosphotase( ALP) ,fasting blood glucose( FBG) , bone γ - carboxyglutamic acid - containing protein( BGP) and fasting insulin (FINS) in blood and Ca/creati-nine(Cr) in urine. According to BMI ≥25kg/m2, every group were divided obese sub - group and nonobese subgroup. On the basis of FBG and FINS, insulin resistance index (IR = FBG × FINS/22.5 ) , insulin action index(IAI = 1/FBG × FINS) and insulin secretion (IS = FINS/FBG) were calculated. Results BGP of type 2 diabetes group were lower obviously beside the normal (P <0. 01). The nonobese were lower beside the obese group(P<0.01). BGP of the early diabetes ( <5 years) were decreased (P<0. 01) ;The Ca/Cr in urine of type 2 diabetes group were higher obviously the control ( P < 0.05) , IR of type 2 diabetes group were increased (P<0.01) ,The sub -group among type 2 diabetes group,the IR.IAI and IS,there were obviously difference each other. ( P < 0. 05). Conclusion Type 2 diabetes could lead to bone' s metabolic disorder. The metabolism of glucose and IR were the importment reasons.
出处
《贵州医药》
CAS
2003年第6期485-487,共3页
Guizhou Medical Journal
