二膦酸盐对2型糖尿病绝经后妇女骨密度及骨生化指标的影响  

The effect of alendronate on bone biochemical indicator of Type 2 DM postmenopausal women with lower BMD

作　　者：王运林[1] 汪红兵[1] 杨菲[1] 姚汉华[1] 刘晓晴[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院内分泌科,武汉430030

出　　处：《临床内科杂志》2006年第9期595-597,共3页Journal of Clinical Internal Medicine

摘　　要：目的观察二膦酸盐对2型糖尿病绝经后女性患者骨密度以及生化指标的影响。方法2型糖尿病绝经后女性骨密度减低患者55例,随机分为两组,二膦酸盐组和糖尿病对照组,分别给予二膦酸盐10mg/d、维生素B110mg/d;基础用药:钙尔奇D600mg/d,治疗1年。检测治疗前后空腹血糖(FBS)、空腹胰岛素(Ins)、糖基化血红蛋白(HbA1c)。治疗前后采用双能X线骨密度测量仪(DEXA)测量腰椎、髋部骨密度;检测血清骨钙素、尿吡啶酚/尿肌酐(尿PYD/Cr);观察新骨折发生和不良反应。结果二膦酸盐治疗组腰椎骨密度增加1.45%,髋部骨密度增加1.93%;而对照组腰椎、髋部的骨密度分别下降0.7%、2.3%;二膦酸盐治疗组血清骨钙素、尿PYD/Cr分别下降17%、24%。二膦酸盐的不良反应主要为上腹部不适。结论二膦酸盐能提高2型糖尿病绝经后女性患者骨密度;结合补充适量钙剂,是预防和治疗2型糖尿病病人绝经后骨质疏松症的重要手段。Objective The objective of this project was to compare changes in bone mineral density （BMD） and bone biochemical indicator during 1 years of alendronate （ALN） treatment versus place- bo in type 2 diabetic postmenopausal women with lower BMD. Methods 55 postmenopausal women with type 2 diabetic were divided ALN group and control group. The ALN group were treated with 10 mg/d ALN,and control group with placebo. All patients were given caltrate 600 mg/d. BMD at the lumbar spine and hip was measured by dual-energy X-ray absorptiometry at the beginning and end of treatment. Samples were analyzed simultaneously for serum markers of bone formation osteocalcin （BGP） and markers of bone resorption urinary pyridinoline（uPYD） and urinary creatinine（Cr）. We observed occurrence of new bone fracture and adverse effect of ALN. Results In diabetic women, 1 years of ALN treatment was associated with increased BMD at all sites studied, including 1.45% at the lumbar spine and 1.93% at the hip, whereas women in the control group experienced a decrease in BMD about 0.7% at the lumbar spine and 2.3% at the hip. Serum osteocalcin and urine PYD/Cr experienced a decrease about 17% and 24% respectively after ALN treatment. The adverse effect of ALN was mainly epigastric discomfort. Conclusions ALN increased BMD relative to placebo in older women with type 2 diabetes. It is a good method for preventing and treating osteoporosis in menopausal women with type 2 DM combined with supplying calcium.

关 键 词：2型糖尿病 骨质疏松 二膦酸盐 骨密度 

分 类 号：R587.1[医药卫生—内分泌]