阿仑膦酸钠片联合降钙素治疗对T2DM合并骨质疏松患者对IGF-1、PINP和S-CTX水平的影响  

Effect of alendronate tablets combined with calcitonin therapy on IGF-1,PINP and S-CTX levels in patients with T2DM combined with osteoporosis

作　　者：卫兰香[1] 王逸骏 熊伟[1] Wei Lanxiang;Wang Yijun;Xiong Wei(Department of Endocrinology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]中国中医科学院西苑医院内分泌科,北京100091 [2]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《中华内分泌外科杂志》2023年第5期554-558,共5页Chinese Journal of Endocrine Surgery

基　　金：国家科技基础条件平台建设项目(2005DKA21404)。

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松(osteoporosis,OP)患者采用阿仑膦酸钠片与降钙素联合治疗的效果及对胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、1型前胶原氨基端延长肽(procollagen typeⅠamino terminal lengthening peptide,PINP)和Ⅰ型胶原交联C末端肽(c-terminal telopeptide of typeⅠcollagen,S-CTX)水平的影响。方法采用随机对照实验原则,选取中国中医科学院西苑医院2021年2月至2022年2月130例患者作为研究对象,根据随机信封法按照1∶1比例分为对照组、观察组,各65例。对照组采用降钙素治疗,观察组采用阿仑膦酸钠片联合降钙素治疗,均连续治疗6个月。统计对比两组疗效、骨密度、血糖相关指标[空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(2h postmeal blood glucose level,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HAb1c)含量]、25羟基维生素D[25 hydroxyvitamin D,25(OH)D]、IGF-1、PINP、S-CTX、不良反应。结果观察组总有效率98.46%,高于对照组86.15%(P<0.05);治疗6个月后观察组左股骨颈、髋部、腰椎L1~L4正位、Wards三角区域等部位骨密度高于对照组(P<0.05);治疗6个月后观察组P1NP(38.36±3.44 vs 42.77±3.86,t=6.88,P<0.001)、S-CTX(0.36±0.13 vs 0.52±0.13,t=7.02,P<0.001)低于对照组,25(OH)D(31.28±5.96 vs 27.46±5.18,t=3.90,P<0.001)、IGF-1(167.82±39.46 vs 150.86±40.27,t=2.43,P=0.017)水平高于对照组;治疗6个月后观察组FPG、2hPG、HAb1c水平低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿仑膦酸钠片、降钙素联合治疗T2DM合并骨质疏松患者能进一步提高骨密度,调节骨代谢,改善骨质疏松症状,同时还对血糖控制有积极作用。Objective To investigate the effect of combined treatment with alendronate tablets and calcitonin on insulin like growth factor-1(IGF-1),procollagen typeⅠamino terminal lengthening peptide(PINP)and c-terminal telopeptide of typeⅠcollagen(S-CTX)levels in patients with type 2 diabetes mellitus(T2DM)combined with osteoporosis(OP).Methods Using the principle of randomized controlled experiment,130 patients in Xiyuan Hospital,China Academy of Chinese Medical Sciences from Feb.2021 to Feb.2022 were selected as study subjects and divided into control group and observation group according to the randomized envelope method in the ratio of 1:1,65 cases each.The control group was treated with calcitonin and the observation group was treated with alendronate tablets combined with calcitonin,both were treated continuously for 6 months.The therapeutic effect,bone mineral density,blood glucose related indexes[fasting blood glucose(FPG),2 h postmeal blood glucose(2 hPG),glycosylated hemoglobin content(HAb1c)],25 hydroxyvitamin D[25(OH)D],IGF-1,PINP,S-CTX,and adverse reactions were statistically compared between the two groups.Results The total effective rate of the observation group was 98.46%,higher than that of the control group 86.15%(P<0.05);After 6 months of treatment,the bone mineral density of left femoral neck,hip,lumbar spine L1-L4 and Wards triangle in the observation group was higher than that in the control group(P<0.05)(P<0.05);After 6 months of treatment,the levels of PINP(38.36±3.44 vs 42.77±3.86,t=6.88,P<0.001)and S-CTX(0.36±0.13 vs 0.52±0.13,t=7.02,P<0.001)in the observation group were lower than those in the control group,while the levels of 25(OH)D(31.28±5.96 vs 27.46±5.18,t=3.90,P<0.001)and IGF-1(167.82±39.46 vs 150.86±40.27,t=2.43,P=0.017)were higher than those in the control group;FPG,2 hPG and HAb1c levels in the observation group were lower than those in the control group after 6 months of treatment(P<0.05);The difference was not statistically significant when comparing the incidence of advers

关 键 词：2型糖尿病 骨质疏松 阿仑膦酸钠片 降钙素 

分 类 号：R587.1[医药卫生—内分泌] R580[医药卫生—内科学]