CAJ | 학술논문

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68例、1型DM患者54例和健康人62例的BMD,放免法测定血清骨钙素、降钙素和25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HbAlc水平均显著高于对照组(P《0.01),血清骨钙素水平显著低于对照组(P《0.01);②2型DM组BMI、大转子BMD显著高于对照组和1型DM组(BMI,P《0.0l;BMD,P《0.05);1型DM组股骨颈BMD低于对照组和2型DM组(P《0.05),经BMI纠正后,1型DM组股骨颈BMD仍低于对照组(P《0.05);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《0.05),2型DM组腰椎和大转子BMD与全血HbAlc水平呈负相关(P《0.05).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;骨转化降低以及糖尿病代谢紊乱可能参与了糖尿病骨质疏松的发生.
목적관찰DM환자골밀도(bone mineral density,BMD)급기상관격소적개변,병탐토기발생궤제.방법채용쌍능(선흡수법측량2형DM환자68례、1형DM환자54례화건강인62례적BMD,방면법측정혈청골개소、강개소화25간유생소D3,면역방사법측정혈청완정갑상방선소급I형효원최기말단전태.결과①량조DM환자전혈HbAlc수평균현저고우대조조(P《0.01),혈청골개소수평현저저우대조조(P《0.01);②2형DM조BMI、대전자BMD현저고우대조조화1형DM조(BMI,P《0.0l;BMD,P《0.05);1형DM조고골경BMD저우대조조화2형DM조(P《0.05),경BMI규정후,1형DM조고골경BMD잉저우대조조(P《0.05);③1형DM조각위점BMD여혈청I형효원최기말단전태수평정부상관(P《0.05),2형DM조요추화대전자BMD여전혈HbAlc수평정부상관(P《0.05).결론여건강인군상비,1형DM환자BMD명현강저,2형DM환자BMD명현증고,단경BMI규정후,저충차이성소실;골전화강저이급당뇨병대사문란가능삼여료당뇨병골질소송적발생.
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.