波动性高血糖对糖尿病合并骨质疏松症的影响分析  

Analysis on Influence of Fluctuating Hyperglycemia on Diabetes Mellitus with Osteoporosis

作　　者：王思明 王铎霖 钱卫斌[3] 蔡欣蕊 姜群群 Wang Si-ming;Wang Duo-lin;Qian Wei-bin;Cai Xin-rui;Jiang Qun-qun(Department of Endocrinology,The No.970 Hospital of Joint Logistic Support Force of Chinese PLA1,Yantai 264100,Shandong Province,China;Grade 2020,Third Clinical Department,Shanxi Medical University2,Jinzhong 030600,Shanxi Province,China;Department of Pulmonology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine3,Ji'nan 250011,Shandong Province,China;Center of Toxicology,Affiliated Occupational Disease Hospital of Shandong First Medical University4,Tai'an 250062,Shandong Province,China;Department of Endocrinology,The No.970 Hospital of Joint Logistic Support Force of Chinese PLA5,Yantai 264100,Shandong Province,China)

机构地区：[1]中国人民解放军联勤保障部队第九七〇医院内分泌科,山东烟台030600 [2]山西医科大学临床三系,山西晋中250011 [3]山东中医药大学附属医院肺病科,山东济南250062 [4]山东第一医科大学附属职业病医院毒理学中心,山东泰安264100 [5]中国人民解放军联勤保障部队第九七〇医院内分泌科,山东烟台

出　　处：《中国社区医师》2022年第34期26-28,共3页Chinese Community Doctors

基　　金：济南市科技发展创新计划重点项目(编号:201805009)。

摘　　要：目的:观察波动性高血糖对糖尿病合并骨质疏松症的影响。方法:选取2018年3月-2019年5月中国人民解放军联勤保障部队第九七〇医院内分泌科收治的50例糖尿病合并骨质疏松症患者为研究对象,随机分为治疗组(n=30)与对照组(n=20)。治疗组采用胰岛素控制血糖,对照组不予干预,比较两组患者血糖水平、骨形成生化指标及骨吸收指标[骨钙素(OST)、血清Ⅰ型胶原氨基端延长肽(P1NP)、β-Ⅰ型胶原羧基端肽(β-CTX)]。结果:治疗后6、12个月,治疗组HbA1c、SDBG、PPGE、LAGE水平低于对照组,治疗后6、12个月,治疗组腰椎(L1~4)及股骨颈骨密度高于治疗前,治疗后12个月,治疗组患者的腰椎(L1~4)及股骨颈骨密度高于对照组,治疗后6、12个月,治疗组OST、β-CTX高于治疗前及对照组,P1NP低于治疗前及对照组,差异均有统计学意义(P<0.05)。结论:波动性高血糖对骨质疏松症无明显获益,随血糖控制平缓及达标后,可改善患者骨密度,促进骨形成生化指标(OST、β-CTX)分泌,降低骨吸收指标(P1NP)水平,缓解骨质疏松进展。Objective: To observe the influence of fluctuating hyperglycemia on diabetes mellitus with osteoporosis. Methods: From March 2018 to May 2019, 50 patients with diabetes mellitus and osteoporosis admitted to the Department of Endocrinology of The No. 970 Hospital of Joint Logistic Support Force of Chinese PLA were selected as the study subjects and randomly divided into treatment group(n=30) and control group(n=20). The treatment group used insulin to control blood glucose, and the control group received no intervention. The blood glucose level, bone formation biochemical indexes and bone resorption indexes [osteocalcin(OST), serum type I collagen amino-terminal elongation peptide(P1NP), β-C-terminal telopeptide of type I collagen(β-CTX)] in two groups were compared. Results: At 6 and 12 months after treatment, the levels of HbA1c, SDBG, PPGE, and LAGE in the treatment group were lower than those in the control group;At 6 and 12 months after treatment, the bone density of the lumbar spine(L1-4) and femoral neck in the treatment group was higher than that before treatment, at 12 months after treatment, the bone density of the lumbar spine(L1-4) and femoral neck in the treatment group was higher than that in the control group;at 6 and 12months after treatment, the OST and β-CTX in the treatment group were higher than those before treatment and in the control group, and the P1NP was lower than that before treatment and in the control group, and the difference was statistically significant(P<0.05). Conclusion: Fluctuating hyperglycemia has no obvious benefit to osteoporosis, after blood glucose is controlled to be stable and reach the standard, it can improve the bone density of patients, promote the secretion of bone formation biochemical indexes(OST, β-CTX), reduce the level of bone absorption index(P1NP), and alleviate the progress of osteoporosis.

关 键 词：血糖波动 糖尿病 骨质疏松症 骨密度 骨代谢标志物 

分 类 号：R587.2[医药卫生—内分泌] R580[医药卫生—内科学]