2型糖尿病患者骨密度、血清微量元素与胰岛功能及慢性并发症的相关性研究  

Correlation Analysis between Bone Mineral Density,Serum Trace Elements and Islet Function,Chronic Complications in Patients with Type 2 Diabetes Mellitus

作　　者：刘婵[1] 李佳芮[1] 郭梦君 王晓菲 郭丽娜[1] 宋春雨 张志君[1] LIU Chan;LI Jia-rui;GUO Meng-jun;WANG Xiao-fei;GUO Li-na;SONG Chun-yu;ZHANG Zhi-jun(The Third Department of Endocrinology and Diabetes,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院内分泌糖尿病三科,河北沧州061000

出　　处：《解放军医药杂志》2022年第7期49-52,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：沧州市重点研发计划指导项目(204106109)。

摘　　要：目的探讨2型糖尿病(T2DM)患者骨密度(BMD)、血清微量元素与胰岛功能及慢性并发症的相关性。方法选取2020年8月—2021年8月250例T2DM,根据并发症类型分为糖尿病周围血管病变(PVD)组、糖尿病视网膜病变(DR)组、糖尿病肾病(DN)组、糖尿病周围神经病变(DPN)组及单纯糖尿病组各50例,并选取体检健康人群50例作为对照组。入组者均检测BMD、血清微量元素与胰岛功能,比较各组间指标的差异,并分析各指标与T2DM慢性并发症的相关性。结果PVD组、DR组、DN组及DPN组糖化血红蛋白(HbA1c)、餐后2 h胰岛素(INS)、血清碱性磷酸酶(ALP)水平均高于单纯糖尿病组,25-羟维生素D、BMD、血钙、血镁水平均低于单纯糖尿病组(P<0.05);DPN组HbA1c、餐后2 h INS、ALP水平最高,空腹INS、BMD、血镁、血磷水平最低(P<0.05);DN组、DPN组骨钙素水平均低于PVD组、DR组(P<0.05);DN组血钙低于除DPN组外的其余各组(P<0.05)。BMD水平与HbA1c及餐后2 h INS水平均呈负相关(r=-2.974、-3.247,P<0.05),与血钙、血磷、血镁均呈正相关(r=4.124、3.415、3.423,P<0.05)。结论T2DM不同慢性并发症患者发生骨代谢异常的机制不尽相同,但均与血糖控制不佳而导致血管病变有关,DPN、DN患者表现最为严重,其BMD水平与血糖、INS及血清微量元素水平均具有相关性。Objective To investigate the correlation of bone mineral density(BMD)and serum trace elements with islet function and chronic complications in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 250 patients with T2 DM who were admitted from August 2020 to August 2021 were selected and divided into diabetic peripheral vascular disease(PVD)group(n=50),diabetic retinopathy(DR)group(n=50),diabetic nephropathy(DN)group(n=50),diabetic peripheral neuropathy(DPN)group(n=50)and simple diabetes mellitus(DM)group(n=50)according to the type of complications.Another 50 healthy people who underwent physical examination were selected as the control group.BMD,serum trace elements and pancreatic islet function were detected in all participants,the differences between the groups were compared,and the correlation between each index and chronic complications of T2 DM was analyzed.Results The levels of glycosylated hemoglobin(HbA1 c),postprandial 2 h insulin(2 h INS)and serum alkaline phosphatase(ALP)in PVD group,DR group,DN group and DPN group were higher than those in simple DM group,while 25-hydroxyvitamin D,BMD,serum calcium,and serum magnesium levels were lower than those in the simple DM group(P<0.05).The DPN group had the highest levels of HbA1 c,2 h INS,and ALP,and the lowest levels of fasting INS,BMD,serum magnesium,and serum phosphorus(P<0.05).The level of osteocalcin in the DN group and DPN group was lower than that in the PVD group and the DR group(P<0.05);the serum calcium in the DN group was lower than that in the other groups except the DPN group(P<0.05).BMD levels were negatively correlated with HbA1 c and 2 h INS(r=-2.974,-3.247,P<0.05),and positively correlated with serum calcium,serum phosphorus and serum magnesium(r=4.124,3.415,3.423,P<0.05).Conclusion The mechanisms of abnormal bone metabolism in patients with different chronic complications of T2 DM are different,but they are all related to vascular lesions caused by poor blood sugar control.DPN and DN patients have the most serious symptoms,and th

关 键 词：糖尿病 2型 糖尿病并发症 骨密度 镁 胰岛功能 相关性 

分 类 号：R587.1[医药卫生—内分泌]