CAJ | 학술논문

目的探讨绝经后2型糖尿病患者血清甲状旁腺素（PTH）、25羟维生素 D[25（OH）D3]、N －端骨钙素（N-MID-OT）、总1型胶原氨基端延长肽（T-P1NP）及β-胶原特殊序列（β-CTX）的变化及其与骨密度变化的相关性。方法选取绝经后2型糖尿病患者81例，根据骨密度水平分为3组，骨量正常组35例、骨量减少组31例和骨质疏松组15例。测量患者身高、体质量，计算体质量指数（BMI）；测定患者空腹血糖（FPG）、血脂、糖化血红蛋白（HbAl c）、血钙（Ca）、血磷（P）、血碱性磷酸酶（ALP）及 PTH、25（OH）D3、N-MID-OT、总1型胶原氨基端延长肽（T-P1NP）、β-胶原特殊序列（β-CTX）的水平。结果三组患者的年龄、病程、FPG、血 Ca、P、ALP、血脂及 PTH 水平差异无统计学意义（P ＞0．05）；骨质疏松组的 BMI 水平较骨量正常组、骨量减少组低，骨量减少组的 BMI 水平较骨量正常组低（P ＜0．05）；与骨量正常组及骨量减少组比较，骨质疏松组的 HbAl c 水平降低，（P ＜0．05）；与骨量正常组比较，骨量减少组及骨质疏松组的25（OH）D3、N-MID、T-P1NP 水平降低（P ＜0．05），β-CTX 水平升高（P ＜0．05）。Pearson 相关分析提示骨密度与 BMI、25（OH）D3、N-MID、T-P1NP 呈正相关，与年龄及β-CTX 呈负相关。结论绝经后2型糖尿病患者易合并骨量减少或骨质疏松，其骨密度变化与骨代谢标志物、25（OH）D3水平、年龄及血糖控制情况有关。
목적탐토절경후2형당뇨병환자혈청갑상방선소（PTH）、25간유생소 D[25（OH）D3]、N －단골개소（N-MID-OT）、총1형효원안기단연장태（T-P1NP）급β-효원특수서렬（β-CTX）적변화급기여골밀도변화적상관성。방법선취절경후2형당뇨병환자81례，근거골밀도수평분위3조，골량정상조35례、골량감소조31례화골질소송조15례。측량환자신고、체질량，계산체질량지수（BMI）；측정환자공복혈당（FPG）、혈지、당화혈홍단백（HbAl c）、혈개（Ca）、혈린（P）、혈감성린산매（ALP）급 PTH、25（OH）D3、N-MID-OT、총1형효원안기단연장태（T-P1NP）、β-효원특수서렬（β-CTX）적수평。결과삼조환자적년령、병정、FPG、혈 Ca、P、ALP、혈지급 PTH 수평차이무통계학의의（P ＞0．05）；골질소송조적 BMI 수평교골량정상조、골량감소조저，골량감소조적 BMI 수평교골량정상조저（P ＜0．05）；여골량정상조급골량감소조비교，골질소송조적 HbAl c 수평강저，（P ＜0．05）；여골량정상조비교，골량감소조급골질소송조적25（OH）D3、N-MID、T-P1NP 수평강저（P ＜0．05），β-CTX 수평승고（P ＜0．05）。Pearson 상관분석제시골밀도여 BMI、25（OH）D3、N-MID、T-P1NP 정정상관，여년령급β-CTX 정부상관。결론절경후2형당뇨병환자역합병골량감소혹골질소송，기골밀도변화여골대사표지물、25（OH）D3수평、년령급혈당공제정황유관。
Objective To assess the correlation between the changes of bone mineral density and serum par-athyroid hormone(PTH),25-hydroxyvitamin D[25(OH)D3],N-terminal-midfragment of osteocalcin (N-MID-OT), total N-terminal propeptide of type I procollagen (T-P1NP)and β-collagen specific sequences (β-CTX)in postm-enopasual women with type 2 diabetes mellitus.Methods 81 postmenopausal women with type 2 diabetes mellitus were recruited and divided into three groups according to the level of bone mineral density,including the control group (n =35),the osteopenia group(n =31)and osteoporosis group(n =15),The height and weight were measured,the level of fasting plasma glucose (FPG),serum lipid,total glycated hemoglobin(HbA1 c),calcium,phosphorus,magne-sium,alkaline phosphatase (ALP),PTH,25 (OH)D3,N-MID-OT,T-P1NP and β-CTX,and the weight mass index (BMI)was calculated.Results There were no significantly differences in FPG,calcium,phosphorus,ALP,serum lipid,PTH levels among the three groups.The levels of Body Mass Index(BMI)and HbA1c in osteoporosis group were lower than those in osteopenia group and control group(P <0.05).The levels of serum 25(OH)D3,N-MID and T-P1NP in groups of osteoporosis and osteopenia were lower than those in control group,while the level of serum β-CTX was on the contrary.The Pearson correlation analysis showed that bone mineral density were significantly positively correlated with the level of BMI ,25(OH)D3,N-MID and T-P1NP ,while the opposite trends were found with the lev-el of age and serum β-CTX .Conclusions The osteoporosis or osteopenia are most likely occur in postmenopasual women with type 2 diabetes mellitus and the changes of bone mineral density is closely correlated with to bone turn-over marker,25(OH)D3,age and the level of blood glucose.