老年NIDDM患者骨代谢生化指标的改变及意义

The Significance and The Changes of Bone Metabolic Index in Old Patients With type 2 Diabetes Mellitus

目的 研究老年非胰岛素依赖型糖尿病(NIDDM)骨代谢生化指标的水平变化,探讨其代谢特点及发病机理。方法 以放射免疫标记法(RIA)测定50例老年NIDDM患者及46例年龄相匹配的健康对照者的血清骨钙素(BGP)、甲状旁腺素(PTH),以生物化学法测定血清总碱性磷酸酶(ALP)、血清钙(Ca)、磷(P)、尿钙(尿Ca)、尿磷(尿P)。结果 NIDDM组BGP浓度、ALP活性显著低于对照组(P<0.01),PTH、尿Ca、尿P浓度显著高于对照组(P<0.05),血Ca、血P浓度与对照组相比无明显差异(P>0.05)。结论NIDDM骨代谢特点为骨吸收增加,骨形成下降。发病机理主要是血糖升高,尿钙、磷排泄增加,刺激甲状旁腺功能活跃,溶骨作用增强,引起骨质疏松。

Objective To study the changes of bone metabolic index in old patients with type 2 diabetes mellitus and to explore the specialty and the mechanism. Methods The levels of the serum boneglaprotein (BGP)、 parathyroid hormone (PTH) were measured with RIA and the levels of the the serum alkaline phosphatase (ALP)、 serum calcium (Ca)、 serum phosphor (P)、 urinary calcium (urinary Ca)、 urinary phosphor (urinary P) were determined with biochemical method in 50 old patients with type 2 diabetes mellitus, while inspecting the age-matched control group. Results The concentrations of BGP and the activities of ALP in old patients with NIDDM are significantly lower than these in the control group (P<0. 01) , The concentrations of PTH、urinary Ca and urinary P are significantly higher than control (P<0.05). There are no difference in the concentrations of serum Ca and P between the two groups (P>0.05). Conclusions: The bone metabolic in NIDDM is characterized by high bone absorption rate and low bone formation rate. The mechanism is mostly considered as not only the higher glucose, the increased loss of urinary Ca and P, but also the ac-tivitied parathyroid function, which result in osteoporosis.