2型糖尿病患者六项性激素与骨密度的相关性研究

Relationship Between Serum Sex Hormone and Bone Mineral Density in Patients with Type 2 Diabetes

探讨2型糖尿病男性患者六项性激素水平与骨密度(BMD)的关系。应用RIA检测49例男性2型糖尿病患者和46例男性非糖尿病患者血清促卵泡生成激素(FSH)、促黄体生成激素(LH)、垂体泌乳素(PRL)、雌二醇(E_2)、孕酮(P)和睾酮(T)的水平;用双能X线吸收法测定患者桡骨远端BMD,并按其BMD值分为骨质疏松(OP)组、骨量减少(L)组和骨量正常(N)组。结果显示,2型糖尿病组中BMD明显低于非糖尿病组,有显著差异(P<0.05);在糖尿病组OP患者FSH、LH、PRL水平升高,E_2、T、P水平降低,与非糖尿病组OP者比较有显著性差异(P<0.05或P<0.01);与BMD相关因素进行直线回归分析显示:OP患者BMD与FSH、LH、PRL水平呈显著负相关,与T、E_2、P水平呈正相关。作者认为男性2型糖尿病患者伴有骨量丢失与垂体-性腺轴功能失衡有关,性腺激素缺乏更容易患骨质疏松。

To explore the relationship between serum sex hormone level and bone mineral density （BMD） in male patients with type 2 diabetes, the serum levels of sex hormone （FSH, LH, PRL, E2, P and T） were measured by RIA in 49 male patients with type 2 diabetes and 46 male subjects without diabetes. The BMD of all patients in distal radius were measured by dual-energy x-ray absorption method. The patients were divided into 3 groups according to the value of BMD： osteoporosis group （OP）, loss bone mass group （L）, normal bone mass group （N）. The results showed that the BMD in patients with type 2 diabetes were markedly lower than that in patients without diabetes （P〈0.05）. The serum levels of FSH, LH and PRL in OP group with type 2 diabetes were significantly higher than those in OP group without diabetes （P 〈0.05）. The serum E2, T and P levels in OP group with type 2 diabetes were markedly lower than those in OP group without diabetes （P〈0.01）. The serum levels of FSH, LH and PRL were remarkably negatively correlated with BMD. The serum T, E2 and P were positively cot related with BMD. The results suggested that the loss of bone mass in patients with type 2 diabetes is relative to the disturbance of pituitary gonad axis. The patient who lacks gonad hormones was susceptible to osteoporosis.