摘要
目的 探讨男性Ⅱ型糖尿病 (DM2 )患者骨密度 (BMD)改变及其影响因素。方法 测定 5 9例男性Ⅱ型糖尿病患者及3 6例健康男性对照者股骨近端 (Neck、Troch、Ward三角区 )及腰椎 (L2～ 4)正侧位BMD ,血钙 (Ca)、磷 (P)、骨钙素、甲状旁腺素 (PTH )、睾酮 (T)和尿Ca Cr、I型胶原羧基末端肽 (CTX) Cr浓度。根据BMD将DM2 患者又分为无骨质疏松组 (DM A1 )和并发骨质疏松组(DM A2 ) ,测定两组患者的空腹血糖、胰岛素、C肽 ,餐后血糖、胰岛素以及糖化血红蛋白。结果 DM2 组L2～ 4及Ward三角区的BMD明显低于对照组 (P <0 .0 5 ) ,而L2～ 4侧位BMD下降更明显 (P <0 .0 0 1)。DM2 组的骨钙素较对照组显著降低 (P <0 .0 5 ) ;血Ca、P、PTH、T和尿CTX Cr浓度与对照组差异不显著 (P >0 .0 5 ) ;尿Ca Cr比对照组高 2 5 % ,但差异无显著意义 (P =0 .13 7)。DM A2 组的体重指数、血T、尿Ca Cr、餐后血糖和糖化血红蛋白与DM A1 组差异显著 (P <0 .0 5 )。结论 Ⅱ型糖尿病患者由于骨形成和骨转换率降低而骨密度下降 ,腰椎侧位的骨密度检查有助于早期诊断骨质疏松。男性患者中体重指数低、血清睾酮浓度低及血糖控制不良者更易并发骨质疏松。
Objective To study the changes of bone mineral density (BMD) and its affecting factors in male patients with type Ⅱ diabetes mellitus(DM 2). Methods BMD of lumbar spine and proximal femur, some bone metabolism related biochemical parameters and serum testos terone (T) in 59 male patients with type Ⅱ diabetes were measured and compared with those in 36 healthy men. According to BMD, DM 2 were divided into with (DM A 2)and without osteoporosis (DM A 1)group. Parameters for glucose and mineral metabolism were compared between two groups. Results (1)BMD of lumbar spine and Ward's triangle in diabetic patients were significantly lower than that of the controls, among which lateral lumbar spine was the lowest ( P <0.01). (2) In male patients with type Ⅱ diabetes serum osteocalcin was significantly lower than that of the controls ( P <0.05) .Urine calcium to creatinine (Ca/Cr) was higher than that of the controls, but with no statistical significance. (3) There were significant difference of body mass index (BMI), serum testosterone, postprandial blood glucose, glycated hemoglobin and urine Ca/CR between DM A 1 group and DM A 2 group ( P <0.05). Conclusion The decrease of BMD in type Ⅱ diabetes mellitus patients is due to the decrease of bone formation and bone turnover rate. Determination of BMD at lateral lumber spine may contribute to the early diagnosis of osteoporosis. Male patients with low BMI and T and poor control of hyperglycemia are prone to osteoporosis.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2001年第1期84-87,共4页
Journal of Third Military Medical University
