摘要
目的探讨绝经后2型糖尿病患者的骨密度变化与N-端骨钙素（N-MID）、总1型胶原氨基端延长肽（T-P1NP）、B-胶原特殊序列（β-CTX）、25羟维生素D水平〈25（OH）Ds]及胰岛素样生长因子-1（IGF-1）的相关性。方法选取绝经后女性2型糖尿病患者116例，根据骨密度水平进行分3组，骨量正常组29例、骨量减少组49例和骨质疏松组38例。测量患者身高、体质量，计算体质指数。测定患者空腹血糖（FBG）、餐后2h血糖（PPG）、糖化血红蛋白（HbAlc）及24h尿蛋白定量（U-PRO），测定3组患者的N-MID、T-P1NP、BCTX、25（OH）D。及IGF-1的水平，比较3组患者-般临床资料和骨代谢指标并进行统计学分析。结果3组患者的FBG、PPG、HbAlc、病程及25（0H）D。差异无统计学意义（P〉0．05）；与骨量正常组比较，骨量减少组和骨质疏松组的体质指数、IGF-1的水平降低（P〈0．05），T-P1NP、N-MID水平降低（19．85±2．83）txg／L与（12．23±2．75）μg／L、（9．16±2．86）μg／L．（均P〈0．05），（7．12±2．05）μg／L与（5．06±2．38）μg／L、（4．92±2．12）μg／L（均P〈0．05）；24hUPro升高（P〈0．05），8-CTX升高（1．32±0．38）μg／L与（1．97±0．58）μg／L、（2．14±0．73）μg／I．（均P〈0．05）；Logistic回归分析结果显示，骨密度与T-P1NP、IGF-1、25（OH）D3、N-MID、体质指数呈正相关（r值分别为0．35l、0．217、0．213、0．273、0．203，P值分别为0．001、0．01l、0．012、0．001、0．012），与8-CTX、24hUPro呈负相关（r值分别为-0．236±0．216，P值分别为0．013、0．015）。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及IGF-1水平密切相关，对绝经后2型糖尿病患者应进行常规检测，及早防治，避免骨折的发生。
Objective To explore the correlation of bone mineral density （BMD） with levels of N-terminal osteocalcin （N-MID）, total collagen type 1 amino-terminal extension peptide, β-collagen special sequence （β-CTX）, 25-hydroxy vitamin D （25 （OH） D3] and insulin-like growth factor-1 （IGF-1） in postmenopausal women with type 2 diabetes. Methods 116 elderly postmenopausal women with type 2 diabetes were divided into 3 groups according to BMD level： normal group （n= 29）, osteopenic group （n= 49） and osteoporosis group （n= 38）. Body height, weight, body mass index （BMI） were measured. Fasting blood glucose （FBG）, 2-hour postprandial glucose （PPG）, glycated hemoglobin （HbAlc）, 24-hour urinary protein （UPro） and levels of N MID, T-P1NP,- CTX, 25（OH）D3 and IGF-1 were determined. General informations and bone metabolic markers were statistically analyzed and compared between the 3 groups. Results There were no significant differences in levels of FBG, PPG, HbAlc, 25（OH）Da and duration between the 3 groups （all P〈0.05）. For the comparison of normal group with osteopenic and osteoporosis groups, BMI and IGF-1 levels were decreased （both P〈0.05）; T-PINP and N-MID levels were decreased （（19.85±2.83） μg/L vs. （12.23±2.75） μg/L, （9.16±2.86） μg/L; （7.12±2.05） μg/L vs. （5. 06±2.38） μg/L, （4.92±2.12） μg/L, all P%0. 053 ; 24 h urine protein was increased （P〈0.05） ; 13-CTX level was increased （（1. 32 t0. 38）μs. （1.97±0.58） μg/L, （2.14±0.73） 〉g/L, P〈0.053. Logisticregression analysis showed that BMD was positively correlated with total collagen type 1 amino terminal extension peptide, IGF-1, 25（OH）D3, N-MID and BMI （r=0. 351, 0. 217, 0. 213, 0.273, 0. 203, respectively, P〈0.01 or 0.05）, and BMD was negatively correlated with CTX and urinary protein levels （r =0. 236 and r=- 0. 216, P〈 0.05 ）. Conclusions Osteopenia or osteoporosis occurs more often in postmenopausal women with type 2 diabetes. The change of BMD is closely related with bone metabolism markers and IGF-1 level. Routine tests and early prevention can avoid fracture in postmenopausal women with type 2 diabetes.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第11期1206-1208,共3页
Chinese Journal of Geriatrics
关键词
糖尿病
2型
骨密度
骨质疏松
骨钙素
Diabetes, Type 2 Bone mineral density
Osteoporosis Osteoealcin
