老年男性2型糖尿病患者各种钙调激素与骨密度改变的关系  

Relationship between calcium regulation factors and changes of bone mineral density in old male patients with type 2 diabetes mellitus

作　　者：刘杰[1] 苗懿德[1] 高伯山[1] 苟淑芹[1] 

机构地区：[1]北京大学医学部第二临床医学院老年学科核 医学科,北京100044

出　　处：《中国骨质疏松杂志》2004年第4期456-458,共3页Chinese Journal of Osteoporosis

摘　　要：目的测定老年男性2型糖尿病患者各种钙调激素及骨密度,探讨老年男性2型糖尿病患者骨质疏松的发病机理,为其防治提供理论依据。方法用双能X线吸收法测定70例老年男性2型糖尿病患者及60例年龄、体重指数相匹配的对照者的腰椎及髋部骨密度,并采用放免法测定血清骨钙索(BGP)、抗酒石酸酸性磷酸酶(TRAP)、甲状旁腺素(PTH)、降钙素(CT)、1,25(OH)2D3、25(OH)D3、尿羟脯氨酸(HOP)等,两组进行比较。结果 老年男性2型糖尿病患者较对照组骨密度显著降低。血BGP、CT、1,25(OH)2D3浓度低于对照组(P<0.05).TRAP、PTH、尿HOP显著高于对照组(P<0.05)。结论老年男性2型糖尿病患者PTH、CT、1,25(OH)2D3等钙调激素分泌及代谢失常,影响骨代谢,出现糖尿病性骨质疏松,表现为骨吸收增加,骨形成减少与缓慢,骨吸收过程大于骨形成。Objective By measuring the calcium regulation factors and the bone mineral density in old male patients with type 2 diabetes mellitus (DM) , to study the pathogenesis of osteoporosis in patients with type 2 diabetes mellitus, and offer the theoretical basis for its prevention and treatment. Methods Dual energy X-ray absorptiometry (DEXA) was used to determine the bone mineral density(BMD) of the lumbar spines and hip bone in 70 old male patients with type 2 diabetes mellitus. Serum osteocalcin(BGP), tartrate-resistant acid phosphatase (TRAP), alkaline phosphatase ( ALP), urinary hydroxyprolin (HOP), serum parathormone ( PTH) , calcitonin (CT), and 1,25(OH)2D3 were also measured by radioimmunoassay, and were compared with an age-and BMI-matched control group. Results Compared with normal group, the BMD in old male diabetic patients significantly decreased. Serum osteocalcin, calcitonin, 1,25(OH)2D3, 25(OH)D3, were significantly lower than those of the controls (P<0. 05), serum parathyroid hormone, tartrate-resistant acid phosphatase and urinary hydroxyprolin were significantly higher than those of the controls ( P < 0. 05). Conclusions Disturbance of calcium regulation factors[ including of PTH, CT, 1,25(OH)2D3] in old male patients with type 2 diabetes mellitus, affects bone metabolism, resulting in increase of bone resorption and decreasie of bone formation, and eventual diabetic osteoporosis .

关 键 词：老年男性 患者 2型糖尿病 骨密度 钙调激素 PTH 对照组 CT 骨吸收 改变 

分 类 号：R681[医药卫生—骨科学] R587.1[医药卫生—外科学]