摘要
目的探讨胰岛素及降糖药治疗对2型糖尿病患者骨密度的影响。均测量身高、体重,同时分析病程、糖化血红蛋白、空腹胰岛素、血清C-肽、与2型糖尿病骨质疏松的关系,讨论其影响因素和可能的机制。方法收集276例2型糖尿病患者的资料,根据其治疗情况分为胰岛素(A)组及降糖药物(B)组,测定上述两组患者骨密度(BMD)、体重指数(BMI)、血清C-肽、空腹血糖、糖化血红蛋白、并按病程结合年龄分组对比。结果 (1)高龄段两组骨质疏松的发病率无统计学差异;(2)早期及长期使用胰岛素治疗组骨密度较降糖药治疗组高(P<0.01),两组差异显著。(3)骨密度与糖化血红蛋白呈负相关、与空腹胰岛素及血清C-肽呈正相关。结论胰岛素早期干预能延缓并减低患者的骨质疏松发病率及程度,对于高龄及病程大于15年糖尿病患者,胰岛素与降糖药对其骨质疏松的防治作用无明显差异。糖化血红蛋白、空腹胰岛素、血清C-肽对骨质代谢有一定影响。
Objective To observe the effect of insulin and glucose-reducing drug therapy on bone mineral density （BMD） in patients with type 2 diabetes mellitus （T2DM） , to measure the height and weight of all patients, to analyze the relationships among the duration of diabetes （YSM）, glycated hemoglobin （HbAlc）, fasting insulin, serum C-peptide and osteoporosis with T2DM, and to discuss the influencial factors and possible mechanisms of osteoporosis with T2DM. Methods Two hundred and seventy-six patients with T2DM were selected and divided into 2 groups according to the treatment they had received： insulin group （Group A） and glucose-reducing drug group （Group B）. BMD, body mass index （BMI）, serum C-peptide, fasting blood sugar, and HbA1 c of all patients in both groups were tested. The results were compared according to YSM and age division. Results 1） In elderly patients, the incidence of osteoporosis between both groups had no significant difference. 2） BMD of the patients who received early and long-term insulin therapy was higher than that of patients in glucose-reducing drug group, and the difference was significant （P 〈 0. 01 ）. 3） BMD was negatively correlated with HbAlc, while it was positively correlated with fasting insulin and serum C-peptlde. Conclusion Early intervention of insulin can reduce the incidence of osteoporosis and the extent of osteoporosis. Nevertheless, for senior patients or patients with the duration of diabetes for more than 15 years, the effect of insulin or glucose-reducing drugs on the prevention and treatment of osteoporosis has no significant difference. HbAle, fasting insulin, and serum C-peptide have some effect on bone metabolism .
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2012年第10期937-939,886,共4页
Chinese Journal of Osteoporosis
基金
2010年度上海市虹口区卫生局重大科研课题资助项目
关键词
2型糖尿病
胰岛素
骨质疏松
空腹血清C-肽
Type 2 diabetes mellitus
Insulin
Osteoporosis
Fasting serum C-peptide
