中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2014年
7期
494-498
,共5页
张丽侠%辛莹%吴雪%王志芳%李冲%李珊%郑丽丽
張麗俠%辛瑩%吳雪%王誌芳%李遲%李珊%鄭麗麗
장려협%신형%오설%왕지방%리충%리산%정려려
糖尿病,2型%胰岛素抵抗%骨质疏松%骨密度%骨质疏松性骨折%肌肉骨骼生理学现象
糖尿病,2型%胰島素牴抗%骨質疏鬆%骨密度%骨質疏鬆性骨摺%肌肉骨骼生理學現象
당뇨병,2형%이도소저항%골질소송%골밀도%골질소송성골절%기육골격생이학현상
diabetes mellitus,type 2%insulin resistance%osteoporosis%bone density%osteoporotic fractures%musculoskeletal physiological phenomena
目的:探索老年糖尿病患者胰岛素抵抗(IR)对维生素D(vit D)代谢和骨代谢影响。方法纳入2011年01月至2013年12月于本院内分泌科住院的65~89岁的2型糖尿病患者55例。采集病例资料,进行口服葡萄糖糖耐量试验、胰岛素和C肽释放实验,检测骨转换指标、进行双光能X线骨密度检查,分析该组患者葡萄糖代谢、IR对骨代谢的影响。结果血清糖化血红蛋白(HbA1c)水平与血清维生素D3(VitD3)呈负相关(r=-0.42,P=0.019),与甲状旁腺激素(PTH)呈正相关(r=0.40,P=0.05);空腹C肽(FCP)与PTH呈正相关(r=0.46,P=0.015);恒稳态模型评估(HOMA)-β也与PTH呈正相关(r=0.56,P=0.004);HOMA-C肽(CR)与骨钙素(OCN)呈正相关(r=0.461,P=0.031),也和PTH呈正相关(r=0.43,P=0.028)。空腹血糖、HbA1c以及HOMA-β、HOMA-CR以及骨转换指标和任何部位骨密度T值均无显著相关性。结论在老年糖尿病患者中,改善IR、及时纠正vit D缺乏或不足对预防骨质疏松具有重要临床意义。
目的:探索老年糖尿病患者胰島素牴抗(IR)對維生素D(vit D)代謝和骨代謝影響。方法納入2011年01月至2013年12月于本院內分泌科住院的65~89歲的2型糖尿病患者55例。採集病例資料,進行口服葡萄糖糖耐量試驗、胰島素和C肽釋放實驗,檢測骨轉換指標、進行雙光能X線骨密度檢查,分析該組患者葡萄糖代謝、IR對骨代謝的影響。結果血清糖化血紅蛋白(HbA1c)水平與血清維生素D3(VitD3)呈負相關(r=-0.42,P=0.019),與甲狀徬腺激素(PTH)呈正相關(r=0.40,P=0.05);空腹C肽(FCP)與PTH呈正相關(r=0.46,P=0.015);恆穩態模型評估(HOMA)-β也與PTH呈正相關(r=0.56,P=0.004);HOMA-C肽(CR)與骨鈣素(OCN)呈正相關(r=0.461,P=0.031),也和PTH呈正相關(r=0.43,P=0.028)。空腹血糖、HbA1c以及HOMA-β、HOMA-CR以及骨轉換指標和任何部位骨密度T值均無顯著相關性。結論在老年糖尿病患者中,改善IR、及時糾正vit D缺乏或不足對預防骨質疏鬆具有重要臨床意義。
목적:탐색노년당뇨병환자이도소저항(IR)대유생소D(vit D)대사화골대사영향。방법납입2011년01월지2013년12월우본원내분비과주원적65~89세적2형당뇨병환자55례。채집병례자료,진행구복포도당당내량시험、이도소화C태석방실험,검측골전환지표、진행쌍광능X선골밀도검사,분석해조환자포도당대사、IR대골대사적영향。결과혈청당화혈홍단백(HbA1c)수평여혈청유생소D3(VitD3)정부상관(r=-0.42,P=0.019),여갑상방선격소(PTH)정정상관(r=0.40,P=0.05);공복C태(FCP)여PTH정정상관(r=0.46,P=0.015);항은태모형평고(HOMA)-β야여PTH정정상관(r=0.56,P=0.004);HOMA-C태(CR)여골개소(OCN)정정상관(r=0.461,P=0.031),야화PTH정정상관(r=0.43,P=0.028)。공복혈당、HbA1c이급HOMA-β、HOMA-CR이급골전환지표화임하부위골밀도T치균무현저상관성。결론재노년당뇨병환자중,개선IR、급시규정vit D결핍혹불족대예방골질소송구유중요림상의의。
ObjectiveTodetermine the effects of insulin resistance (IR) on bone metabolism and vitaminDmetabolismin the elderly patients with diabetes mellitus(DM). Methods A total of55 patientswith type 2DMattheage ranging from65to 89yearsadmittedin ourdepartment from January2011to December2013were recruited in this study. All of them weretested for oral glucose tolerance test, insulin release testandC-peptide release test.Serum levels of vitamin D3(VitD3) and parathyroid hormone (PTH),andbiomarkers for bone metabolism, including osteocacin (OCN) and carboxy-terminal β collagen crosslinks(β-CTX) were alsodetected. Bone mineral density (BMD) wasmeasured by dual energy X-ray absorptiometry. Correlation analysis wasperformedon theeffects of glucose metabolism andIR onbone metabolism.Results In the cohort, the serum level ofglycosylated hemoglobin (HbA1c)was negatively correlated with that ofVitD3 (r=-0.42,P=0.019),butpositivelywithPTH (r=0.40,P=0.05). PTH wasalsopositively related to fasting C peptide (FCP)( r=0.40,P=0.015) andHomeostasis Model Assessment(HOMA-β)(r=0.56,P=0.004). Bone formation marker OCN wasinapositive correlation with HOMA-calretnin(HOMA-CR,r=0.461,P=0.031), while PTHwaspositively related to HOMA-CReither(r=0.43,P=0.028). But no correlationwas seen in T values of BMD fromeveryregionof the total bodywith blood glucose, HbA1c, HOMA-β, HOMA-CR and bone metabolic markers.ConclusionFor aged patients with diabetes, it is of great clinical significance to ameliorateIR and timely treatVitD deficiency or insufficiencyin order to preventosteoporosis.