老年男性2型糖尿病患者甲状旁腺素、维生素D与骨密度的关系  

The correlation between PTH, Vitamin D and bone mineral density in elderly man with type 2-diabetes

作　　者：高艳虹[1] 徐锦霞[1] 张江蓉[1] 昌菁[1] 卢维晟[1] 王一尘[1] 潘志红[1] 

机构地区：[1]上海交通大学医学院附属新华医院老年科,200092

出　　处：《中国综合临床》2012年第2期143-145,共3页Clinical Medicine of China

基　　金：基金项目：上海市卫生局科研项目基金资助（2007127）

摘　　要：目的探讨老年男性2型糖尿病患者主要钙调激素甲状旁腺素（PTH）和维生素D的变化对骨密度的影响。方法应用双能X线骨密度仪测定60例老年男性2型糖尿病患者的腰椎和髋部骨密度，检测血清中骨代谢及血糖相关的指标，并根据骨密度测定结果将60例老年男性2型糖尿病患者分为骨量减少组（32例）、骨质疏松组（12例）、正常组（16例），测定3组的血清胛H和25羟维生素D3，分析其与患者不同部位骨密度的相关性。结果依据患者腰椎或髋部的骨密度值，骨质疏松的检出率为20．0％（12／60），骨量减少的检出率为53．3％（32／60）。3组的血清PTH比较差异有统计学意义（F=3．32，P=0．043），骨量减少组、骨质疏松组与正常组相比，PTH水平明显上升[（44．87±10．62）、（50．24±20．32）ug/L与（36．96±12．36）ug／L，P均〈0．05]。但25羟维生素D3浓度3组比较差异无统计学意义（P〉0．05）。相关分析显示，PTH水平与髋部骨矿面密度（BMD）呈显著负相关（r=-0．224，P〈0．05），与腰椎BMD无显著相关性（r=-0．187，P〉0．05）。结论老年男性2型糖尿病患者的髋部BMD与血清VTH浓度负相关。Objective To explore the impact of Calciotropic hormones, such as parathyroid hormone （PTH） and vitamin D,on bone mineral density （BMD） in the old men with type 2-Diabetes. Methods Sixty elderly men with type 2-Diabetes were submitted to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine and hip. Fasting blood samples were collected to evaluate the indexes of bone metablism and blood glucose. PTH and 25-（OH）-Vitamin D3 were measured and analyzed for their correlation with BMD at different sites. Results In all patients, the percentage of osteoporosis and osteopenia accounted for 20. 0% hnd 53.3% of the patients according to BMD at lumbar or hip. Compared with the patient group with normal BMD, serum PTH was significantly higher in the patient group with osteopenia or osteoporsis （ [ 44. 87 ± 10. 62 ] ug/L vs [ 36. 96 ± 12. 36 ] ug/L, P 〈 0. 05 ; [ 50. 24 ± 20. 32 ] ug/L vs [ 36. 96 ± 12. 36 ] ug/L, P 〈 0. 05 ）. But there was no difference in 25-（OH）-Vitamin D3 levels between all groups. PTH was correlated negatively with BMD at hip （ r = - 0. 224, P 〈 0. 05 ）, but not significantly correlated with BMD at lumbar （ t = - 0. 187, P 〉 0. 05 ） . Conclusions Serum PTH was correlated negatively with BMD at hip in elderly man with type 2-Diabetes.

关 键 词：2型糖尿病 骨密度 老年男性 甲状旁腺素 25羟维生素D3 

分 类 号：R580[医药卫生—内分泌]