老年男性2型糖尿病患者骨密度及骨代谢生化指标的研究  

Relationship between bone mineral density, age and bone metabolic markers in old male patients with type 2 diabetes mellitus

作　　者：苗懿德[1] 刘杰[1] 

机构地区：[1]北京大学医学部第二临床医学院老年医学科,100044

出　　处：《中国骨质疏松杂志》2002年第1期38-40,共3页Chinese Journal of Osteoporosis

摘　　要：目的　探讨老年男性 2型糖尿病患者骨密度改变及其机制 ,以了解 2型糖尿病是否易合并骨质疏松及其特点。方法　测定 70例老年男性 2型糖尿病患者及 6 0例年龄、体重指数相匹配的健康对照者的骨密度 ,血清骨钙素 (BGP)、抗酒石酸酸性磷酸酶 (TRAP)、碱性磷酸酶 (ALP)、尿钙(Ca)、尿羟脯氨酸 (HOP)、空腹及餐后血糖、糖化血红蛋白 (HbA1C)等 ,两组进行比较。结果　老年男性 2型糖尿病患者较健康对照组骨密度显著降低。BGP浓度显著低于对照组 (P <0 0 0 1) ;TRAP、甲状旁腺素 (PTH)、尿钙、HOP显著高于对照组 (P <0 0 5 )。糖尿病患者BMD与病程、年龄、HbA1C、FBG、PBG呈显著负相关 ,与平均体重指数 (BMI)呈正相关。结论　老年男性 2型糖尿病患者较易患骨质疏松 ,其骨改变特点是 :骨吸收增加 ,骨形成下降 ;发病机理主要是血糖升高 。Objective\ To investigate the change in bone mineral density(BMD) and its pathophysiology, so as to study the morbidity and pattern of osteoporosis in old male patients with type 2 diabetes mellitus(BM). Methods\ Dual energy X ray absorptiometry(DEXA) was used to determine the BMD in 70 old male type 2 DM patients. Serum osteocalcin(BGP), tartrate resistant acid phosphatase(TRAP), alkaline phosphatase(ALP),urinary calcium(Ca), hydroxyprolin (Hop), fasting blood glucose(FBG),postprandial blood glucose(PBG) and hemoglobin A 1C were also measured, and were compared with an age and BMI matched control group. Results\ Compared with normal group, the BMD in old male diabetic patients signficicantly decreased. Serum osteocalcin was significantly lower than that of the controls ( P <0 001). serum parathyroid hormone, TRAP, urinary Ca and Hop were significantly higher than those of the controls. The changes in BMD significantly negatively correlated with duration of disease, age, HbA 1C , FBG, PBG for old male diabetic patients, meanwhile the changes in BMD significantly positively correlated with bone mass index. Conclusion\ There is a higher morbidity of osteoporosis in old male type 2 DM patients. The bone change is characterized by high bone absorption rate and low bone formation rate.The mechanism of osteoporosis is considered as a result of not only the increase in serum glucose, the increased loss of calcium and absorption of bone tissue induced by the secondary hyper parathyroidism, but also the islet cell hypofunction.

关 键 词：2型糖尿病 骨质疏松 骨密度 骨钙素 抗酒石酸酸性磷酸酶 尿羟脯氨酸 

分 类 号：R587.1[医药卫生—内分泌] R681[医药卫生—内科学]