不同分期男性糖尿病肾病患者血清骨代谢指标及骨密度变化研究  

Research on the changes of biochemical markers of bone turnover and bone density in male patients with different stages of diabetic nephropathy

作　　者：梅丽萍[1] 孙星达[1] 阮奕[1] 

机构地区：[1]温州医科大学附属台州医院检验科,浙江台州317000

出　　处：《中国卫生检验杂志》2016年第1期74-77,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨不同分期男性糖尿病肾病(DN)患者血清骨转换指标及骨密度的变化情况。方法 2010年1月-2014年12月,对台州医院610例首诊糖尿病(DM)患者(分为单纯DM组、早期DN组、临床期DN组)及207例健康体检者的骨密度及血清骨转换指标进行统计分析。结果单纯DM组、早期DN组及临床期DN组血清钙(Ca2+)、血清磷(P)、骨钙素N端中分子片段(N-MID)、25羟维生素D(25-OH Vit D)、睾酮(TESTO)水平、腰椎及脊柱骨密度呈逐渐下降趋势,β-胶原降解产物(β-CTX)及甲状旁腺素(PTH)水平呈逐渐上升趋势,差异均有统计学意义(P<0.001)。25-OH Vit D与3组的骨密度具有较高的正相关性,r值分别为0.677、0.728、0.757,P<0.001;N-MID与3组的骨密度具有较高的负相关性,r值分别为-0.415、-0.515、-0.615,P<0.001。结论男性DN患者骨密度随病情发展呈逐渐降低趋势,25-OH Vit D及N-MID可作为DN的重要监测指标。Objective To investigate the changes of biochemical markers of bone turnover and bone density in male patients with different stages of diabetic nephropathy. Methods We collected clinical data and biochemical markers of bone turnover and bone density from 610 patients （simple DM group, early DN group and clinical stage DN group） with diabetes mellitus who were treated in Taizhou Hospital from January 2010 to December 2014 and from 207 normal healthy controls, which were statisti- cally analyzed. Results The serum calcium（ Ca^2＋ ）, serum phosphorus （P）, the N end osteocalcin （N -MID）, the 25 hydroxyl vitamin D（25 -OH VitD） and testosterone （TESTO） level, bone mineral density of the lumbar spine and spine in simple DM group, early DN group and clinical stage DN group decreased gradually, and the levels of β - CTX and PTH increased gradually, and the differences were statistically significant（ P 〈 0.001 ）. VitD 25 - OH and the bone mineral density of 3 groups had a high positive correlation, r values were 0. 677, 0. 728, 0. 757, P 〈 0.001 ; the N - MID and the bone mineral density of 3 groups had a high negative correlation, r values were -0.415, -0. 515, -0. 615, P 〈 0.001. Conclusion The bone density of male DN patients gradually decreased with the development of the disease, and VitD 25 - OH and N - MID could be used as an important monitoring index of DN.

关 键 词：糖尿病肾病 骨密度 骨转换指标 

分 类 号：R587.1[医药卫生—内分泌]