男性2型糖尿病合并骨质疏松患者骨生化指标改变

Changes of bone biochemic markers in male patients with type 2 diabetes with osteoporosis

目的 探讨男性 2型糖尿病 (DM)中合并骨质疏松患者骨生化指标的改变及其机制。方法 根据骨密度检测结果 ,将 5 9例男性 2型糖尿病患者分为无骨质疏松组 (DM A1)和合并骨质疏松组 (DM A2 ) ,分别测定两组的血钙 (Ca)、磷 (P)、骨钙素(BGP)、甲状旁腺素 (PTH)、睾酮 (T)和尿Ca/Cr、I型胶原羧基末端肽 (CTX) /Cr浓度并进行比较。结果 DM A2 组与DM A1组相比 ,DM A2 组的体重指数、血T低 ,尿Ca/Cr高 ,有显著差异 (P <0 .0 5 )。结论 男性 2型糖尿病患者中体重指数低、血清睾酮浓度低者更易并发骨质疏松。

Objective To investigate the change in bone biochemic markers and its mechanism in male patients with type 2 diabetes mellitus(DM).Methods BMD of lumbar spine and proximal femur , in 59 male patients with type 2 diabetes were measured . According to BMD, DM were divided into with (DM-A 2)and without osteoporosis (DM-A 1)groups, several bone biochemic markers and serum testosterone.Results (1) BMD of lumbar spine and Ward's triangle in diabetic patients were significantly lower than that of the controls, which of lateral lumbar spine was the lowest(P<0.001).(2)In male patients with type 2 diabetes serum osteocalin was significantly lower than that of the controls (P<0.05). Urine calcium to creatinin (Ca/Cr ) was higher than that of the controls, but without statistical significance.(3) There were significant differences of body mass index (BMI), serum testosterone (T),and urine Ca/Cr between DM-A 1 group and DM-A 2 group(P<0.05).Conclusion Because of low bone formation and bone turnover rate, BMD in type 2 diabetes mellitus patients decrease. Measurements of BMD at lateral lumber spine may contribute to diagnosing osteoporosis as soon as passible. The male patients with low BMI and T are prone to ostoporosis.