男性糖尿病患者25(OH)VD与骨密度等指标关系的研究  

Relationship of 25(OH)VD with Bone Mass and Other Indicators in Male Patients with Diabetes Mellitus

作　　者：安振梅[1] 黄明洁[1] 张玫[1] 熊中云[1] 郭丹[1] 

机构地区：[1]四川大学华西医院实验医学科激素检测室,成都610041

出　　处：《四川大学学报（医学版）》2009年第1期52-54,共3页Journal of Sichuan University(Medical Sciences)

摘　　要：目的探讨男性糖尿病患者25(OH)VD与骨密度及其它指标的关系。方法纳入82例男性糖尿病患者,其中骨质疏松患者49例,非骨质疏松患者33例,检测其骨密度、血清中25(OH)VD水平及其它指标。结果①骨质疏松组与非骨质疏松组相比,25(OH)VD、睾酮(T)、硫酸脱氢表雄酮(DHEA-S)、骨特异性碱性磷酸酶(B-ALP)水平明显降低(P<0.05),抗酒石酸酸性磷酸酶-5b(TRCAP-5b)明显增高(P<0.05),甲状旁腺激素(PTH)、尿白蛋白/肌酐(UAlb/Cr)有升高的趋势,但差异均无统计学意义(P>0.05)。糖化血红蛋白(HBA1c)两组比较无统计学意义;②在骨质疏松组和非骨质疏松组,25(OH)VD水平与年龄未显示相关性,与病程呈负相关(P<0.05)。两组中25(OH)VD均与股骨颈、Ward三角区T值、大转子T值、腰椎T值呈正相关(P<0.05),与T、DHEA-S也呈正相关(P<0.05)。骨质疏松组25(OH)VD与PTH呈负相关(P<0.05),而非骨质疏松组25(OH)VD与PTH无相关。两组中25(OH)VD与B-ALP呈正相关(P<0.05),而与TRCAP-5b、HbA1c、UAlb/Cr均未显示相关性。结论25(OH)VD、T、DHEA-S降低可能是男性糖尿病骨质疏松的重要因素。Objective To investigate the relationship of serum 25- Hydroxy D with bone mass density and other indicators in male patients with diabetes. Methods Bone mass density （BMD）, serum 25- HydroxyD （25 （OH）VD） and several other biochemical indicators were measured in 82 male patients with diabetes, among whom 49 had osteoporosis. Results The diabetic patients with osteoporosis had higher tartrate-resistant acid phosphatase- 5b （TRCAP-5b） and lower 25 （OH） VD,testosterone（T）,Dehydroepiandrosterone sulfate（DHEA-S） ,and bone-specific alkaline phosphatase （B-ALP） than those without osteoporosis （P〈0.05）. The Parathormone （PTH） and albumin-creatinine ratio（UAlb/Cr） also increased in the diabetic patients with osteoporosis, but with no statistical significance. No difference was observed in glycosylated hemoglobin（HBA1c） between the diabetic patients with and without osteoporosis. The serum 25 （OH）VD was negatively correlated with the duration of diabetes in both groups （P〈0.05）, which was independent from the increase of age. The serum 25（OH）VD was positively correlated with T score of neck, ward, greater trochanter of femur and vertebrae lumbales, and T and DHEA-S in both patients with and without osteoporosis （P〈0.05）. The 25（OH）VD was also positively correlated with PTH in the patients with osteoporosis. Negative correlation was noted between 25 （OH）VD and B-ALP. There were no correlations between 25（OH）VD and TRCAP-5b, HBA1c and UA1b/Cr. Conclusion s Serum 25（OH）VD,T and DHEA-S may play an important role in the development of osteoporosis in male patients with diabetes mellitus.

关 键 词：25(OH)VD 糖尿病 骨质疏松 

分 类 号：R587.1[医药卫生—内分泌] R580[医药卫生—内科学]