2型糖尿病患者糖化血红蛋白水平与骨代谢的关系  

Relationship between glycosylated hemoglobin level and bone metabolism in patients with type 2 diabetes mellitus

作　　者：吴雪[1] 盛昭 张维[1] 季学磊 姚新明[2] WU Xue;SHENG Zhao;ZHANG Wei;JI Xue-lei;YAO Xinming(Department of Endocrinology,Wuhu Hospital Affiliated to East China Normal University,Wuhu 241000,China)

机构地区：[1]华东师范大学附属芜湖医院内分泌科,芜湖241000 [2]皖南医学院附属弋矶山医院内分泌科,芜湖241000

出　　处：《武警后勤学院学报（医学版）》2021年第9期42-43,46,共3页Journal of Logistics University of PAP（Medical Sciences）

基　　金：安徽省自然科学研究基金(No.1608085QH191);安徽省重点研究与开发计划(No.202004j07020050)。

摘　　要：【目的】探讨2型糖尿病(T2DM)患者体内骨代谢情况及其与糖化血红蛋白(HbA1C)水平的相关性。【方法】回顾性分析2019年6月至2020年6月在华东师范大学附属芜湖医院内分泌科住院的T2DM患者的临床资料(n=92),包括一般情况、生化指标及25-(OH)维生素D、β胶原特殊序列(CROSSL)、总Ⅰ型胶原氨基延长肽(T-PINP)、骨钙素(OSTEOC)等骨代谢指标,左侧股骨颈骨密度(T-Score)。按照HbA1C水平分为3组(血糖良好组、血糖一般组、血糖不佳组),并将3组上述相关数据进行比较。【结果】与血糖控制不佳组比较,血糖良好组和血糖一般组患者血清25-(OH)维生素D、T-PINP、T-Score明显升高(P<0.05)。25-(OH)维生素D是骨质疏松的保护因素,HbA1C、空腹血糖是骨质疏松的危险因素。【结论】血糖控制不良的T2DM患者的骨吸收增加,髋骨骨密度下降。临床工作中需加强干预措施,重视骨质疏松的防治。【Objective】To investigate the relationship between bone metabolism and glycosylated hemoglobin(HbA1C)in type 2 diabetes mellitus(T2DM)patients.【Methods】The clinical data of T2DM patients hospitalized in the Department of Endocrinology,Wuhu Hospital Affiliated to East China Normal University from June 2019 to June 2020(n=92),including general conditions,biochemical indexes,25-(OH)vitamin D β Bone metabolism indexes such as collagen special sequence(CROSSL),total type I collagen amino lengthening peptide(T-PINP),osteocalcin(OSTEOC),and left femoral neck bone mineral density(T-score).They were divided into three groups according to HbA1c level(good blood glucose group,general blood glucose group and poor blood glucose group),and the above relevant data of the three groups were compared.【Results】Compared with the poor blood glucose control group,the serum 25-(OH)vitamin D,T-PINP and T-score in the good blood glucose group and the general blood glucose group were significantly higher(P<0.05).25-(OH)vitamin D is the protective factor of osteoporosis,HbA1c and fasting blood glucose are the risk factors of osteoporosis.【Conclusion】Bone resorption increases and hip bone mineral density decreases in T2DM patients with poor blood glucose control.It is necessary to strengthen intervention measures and pay attention to the prevention and treatment of osteoporosis in clinical work.

关 键 词：2型糖尿病 骨质疏松 糖化血红蛋白 25-羟维生素D 总I型前胶原氨基末端前肽 

分 类 号：R587.1[医药卫生—内分泌]