CAJ | 학술논문

目的：探讨老年2型糖尿病患者的骨密度(BMD)与骨代谢标志物的相关性。方法取大于60岁老年2型糖尿病患者197例，根据BMD水平进行分三组，骨量正常组72例、骨量减少组73例和骨质疏松组52例。测定患者空腹血糖(FBG)、早餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)及尿蛋白定量(U-PRO)，测定三组患者的骨钙素(BGP)、Ⅰ型胶原羧基末端肽(β-CTX)、总骨Ⅰ型前胶原N端肽(TP1NP)及25-羟维生素D [25(OH)D]的水平，比较三组患者一般临床资料和骨代谢指标并进行统计学分析。结果三组患者的FBG、PPG、HbAlc、病程及尿微量白蛋白比较差异均无统计学意义(P>0.05)，而骨质疏松组的BGP、β-CTX和TP1NP与骨量正常组比较均升高，差异均有统计学意义(P<0.05)，BMD与BGP、β-CTX和TP1NP呈负相关(r值分别为-0.191、-0.244、-0.176， P值分别为<0.01、<0.05、<0.05)，与25(OH)D正相关(r=0.325，P<0.01)。结论老年2型糖尿病患者的骨密度与骨代谢标志物存在密切的相关性，联合应用骨代谢标志物的检测有助于老年2型糖尿病患者骨质疏松的早期诊断，减少骨折风险。
목적：탐토노년2형당뇨병환자적골밀도(BMD)여골대사표지물적상관성。방법취대우60세노년2형당뇨병환자197례，근거BMD수평진행분삼조，골량정상조72례、골량감소조73례화골질소송조52례。측정환자공복혈당(FBG)、조찬후2 h혈당(2 hPG)、당화혈홍단백(HbAlc)급뇨단백정량(U-PRO)，측정삼조환자적골개소(BGP)、Ⅰ형효원최기말단태(β-CTX)、총골Ⅰ형전효원N단태(TP1NP)급25-간유생소D [25(OH)D]적수평，비교삼조환자일반림상자료화골대사지표병진행통계학분석。결과삼조환자적FBG、PPG、HbAlc、병정급뇨미량백단백비교차이균무통계학의의(P>0.05)，이골질소송조적BGP、β-CTX화TP1NP여골량정상조비교균승고，차이균유통계학의의(P<0.05)，BMD여BGP、β-CTX화TP1NP정부상관(r치분별위-0.191、-0.244、-0.176， P치분별위<0.01、<0.05、<0.05)，여25(OH)D정상관(r=0.325，P<0.01)。결론노년2형당뇨병환자적골밀도여골대사표지물존재밀절적상관성，연합응용골대사표지물적검측유조우노년2형당뇨병환자골질소송적조기진단，감소골절풍험。
Objective To investigate the relationship between bone mineral density and bone metabllistic markers in elderly patients with type 2 diabetes. Methods A total of 197 elderly patients with type 2 diabetes were di-vided into three groups according to BMD level: normal group (n=72), osteopenic group (n=73) and osteoporosis group (n=52). Fasting blood glucose (FBG), 2-hour postprandial glucose (2 hPG), glycated hemoglobin (HbAlc), uri-nary protein (UPro) and levels of BGP,β-CTX, TP1NP and 25(OH)D were determined. General information and bone metabolic markers were statistically analyzed and compared between the three groups. Results There were no signif-icant differences in 1evels of FBG, 2 hPG, HbAlc, and duration between the three groups (all P>0.05). For the compar-ison of normal group with osteoporosis groups, BGP,β-CTX and TP1NP were increased ( P<0.05), BMD was posi-tively correlated with BGP,β-CTX and TP1NP (r=-0.191, P<0.01;r=-0.244, P<0.05;r=-0.176, P<0.05), and BMD was negatively correlated with 25(OH)D (r=0.325, P<0.01). Conclusion The change of BMD is closely related with bone metabolisitic markers in elderly patients with type 2 diabetes. The combined application of bone metabolistic markers is helpful for the early diagnosis of osteoporosis in elderly patients with type 2 diabetes, and can reduce the risk of fractures.