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2型糖尿病患者骨密度改变的初探 |
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李莉 刘英敏
【摘要】 目的 探讨2型糖尿病患者骨密度(BMD)改变及其机制。方法 测定93例2型糖尿病患者及90例年龄、体重指数相匹配的健康对照者股骨近端(Neck、Troch、Ward三角)及正位腰椎(L2-L4)BMD，血钙(Ca)、磷(P)、甲状旁腺激素(PTH)、尿CrossLap/Cr浓度。结果 2型糖尿病患者股骨近端Neck、Troch、Ward三角、L4、L2-L4骨密度(BMD)比对照组高；L2低于对照组。上述各部位(除外L2)BMD糖尿病5年以下组(DM-A)组高于对照组，糖尿病5年及以上组(DM-B)组低于DM-A组，DM-B组Neck、Troch、L3、L4、L2-L4部位BMD低于对照组。L2部位BMD：在DM-A组低于对照组，而在DM-B组高于DM-A组。将病程与BMD进行相关性分析后显示：病程与股骨近端Neck、Ward三角区BMD呈显著负相关(P＜0.05)。2型糖尿病组血Ca、P浓度与对照组无显著差异；血骨钙素(BGP)浓度显著低于对照组(P＜0.05)；血PTH浓度显著高于对照组(P＜0.05)；尿Crosslaps/Cr比对照组高14%，但差异无显著意义(P＞0.05)。结论 2型糖尿病患者各部位BMD改变不同，其股骨近端Neck部位BMD与病程呈明显负相关(P＜0.05)；2型糖尿病患者骨改变特点是：骨吸收增加，骨转化率降低；继发性甲旁亢可能参与其骨改变。
【关键词】 糖尿病，2型 骨密度 骨钙素
Bone density in patients with type 2 diabetes and its pathophysiology
LI Li,LIU Yingmin.
Department of Internal Medicine,Second Clinical College,China Medical University,Shen Yang,110003
【Abstract】 Objective To investigate into the change in bone mineral density (BMD) and its pathophysiology in patients with type 2 diabetes mellitus (DM). Methods BMD of proximal femur and AP spine and several metabolic parameters in 93 type 2 diabetes mellitus patients, were measured, and were compared with an age-and BMI-matched control group. Results ①type 2 diabetes mellitus patients had higher BMD at femoral neck、troch、Ward s triangle, L4 and L2-L4 and had lower BMD at L2 as compared with normal controls. ②Over all areas studied except L2, DM-A group had higher BMD than normal controls, DM-B group had lower BMD than DM-A group (DM course less than 5 years). At femoral neck,troch,L3,L4 and L2-L4 DM-B group (DM course at least 5 years) had lower BMD than normal controls. At L2, DM-A group had lower BMD than normal controls, and DM-B group had higher BMD than DM-A group. ③In type 2 diabetes mellitus group, the duration of type 2 diabetes mellitus correlated negatively with BMD at femoral neck, troch and Ward s triangle (P＜0.05). ④In type 2 diabetes mellitus patients serum Ca and[1] [2] [3] 下一页
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