2型糖尿病合并骨质疏松患者骨形成指标观察

Clinical detection of bone formation index from type 2 diabetes mellitus with osteoporosis patients

目的探讨2型糖尿病(type2diabetesmellitus,T2DM)合并骨质疏松症(osteoporosis,OP)患者骨形成指标的改变。方法受试者分为4组,即T2DM合并OP组(A组)、T2DM无OP组(B组)、非糖尿病骨质疏松组(C组)和正常对照组(D组),各组年龄、性别、民族和体质量指数等因素具有可比性;观测骨钙素(BGP)、骨特异性碱性磷酸酶(骨AKP)和股骨颈抗骨折能力(FS)等骨形成指标,同步检测尿吡啶醚(PYD)和脱氧吡啶醚(DPD)等骨吸收指标。结果A组患者血清BGP和骨AKP水平明显低于C组和B组,与C组比较分别为(4.74±0.82)μg/Lvs(5.82±1.44)μg/L(P<0.01)和(19.57±5.36)U/Lvs(23.38±7.36)U/L(P<0.05),与B组比较分别为(4.74±0.82)μg/Lvs(5.13±0.96)μg/L和(19.57±5.36)U/Lvs(22.13±6.37)U/L(均P<0.05);A组FS参数(0.43±0.01)P/cm2显著低于C组(0.48±0.04)P/cm2和B组(0.51±0.02)P/cm2(均P<0.01);C组尿PYD和DYD明显高于B组(P<0.01);除FS、BGP外,所有指标参数A、B、C3组均分别显著高于D组(均P<0.01)。结论T2DM合并OP患者骨形成减少大于骨吸收增多,相对绝经后OP是一种低转换速率型骨质疏松。

Objective To investigate the bone formation index from type 2 diabetes mellitus （T2DM） with osteoporosis（OP） patients. Methods Trials were divided into four groups： T2DM with OP patients （group A,36 cases） and T2DM without OP patients （group 13, 42 cases）, non-T2DM with OP patients（group C. 39 cases） and healthy controls （group D, 38 cases）. Among the groups matches existed in age, sex, genus and body mass index （BMI）. Bone formation indices were measured bone osteocalin （BGP）, serum bone specific alkeliphosphatase （bone AKP） and femoral neck strength （FS）, and bone resorption indices： urine pyridinolin（PYD） and deoxypyridinoline （DPD） were determined at the same time. Results Serum BGP and bone AKP in group A decreased, which were significantly lower than those of group C： respectively （4.74 ±0.82） μg/L vs （ 5.82 ± 1.44） μg/L （ P % 0.01 ） and （19.57±5.36） U/L vs （23.38± 7.36） U/L（P〈0.05）; to compare group A with group B： respectively（4.74±0.82） μg/L vs （5.13±0.96） μg/L and （19.57±5.36） vs （22.13±6.37） U/L（all P〈0.05）. FS level in group A （0.43±0.01） P/cm^2 was significantly lower than that in group C （0. 484±0.04） P/cm^2 and group B （0.51 ±0.02） P/cm^2 （all P %0.01）. Urine PYD and DPD levels in group C were signficantly higher than that of group B（ P 〈50.01）. All parameters among groups A,B and C were singnificantly higher than group D（all P〈0.01） except FS and BGP. Conclusion In T2DM complicated with OP patients, more decrease of bone formation than bone resorption in comparison with that postmenopausol OP, it mainly influences the indices of bone formation and may be a lower turnover ratio type.