绝经后女性2型糖尿病骨密度研究

Study of bone mineral density in postmenopause women combine type 2 diabetes

目的探讨女性绝经合并2型糖尿病患者骨密度的变化。方法采用美国Norland双光能X线骨密度检测仪对2009年8月至2010年4月在我科住院的58例患者进行腰椎L2～L4和左侧股骨近端(包括Neck、Troch、Ward三角区)骨密度测量,其中非糖尿病绝经后妇女31例,绝经合并2型糖尿病患者27例,并测定空腹血糖(FBG)、糖化血红蛋白(HbAlc)、甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C),结合年龄、病程、绝经年限等因素进行研究。结果绝经合并2型糖尿病组患者空腹血糖9.71±3.36mmol/L、糖化血红蛋白8.19±1.38、甘油三脂2.25±1.37mmol/L、低密度脂蛋白2.82±0.86mmol/L较对照组非糖尿病绝经组空腹血糖5.60±1.03mmol/L、糖化血红蛋白4.55±0.64、甘油三脂1.31±0.94mmol/L、低密度脂蛋白2.26±1.10mmol/L显著增高(P<0.05);绝经合并2型糖尿病组患者Neck、Ward三角区、Troch的骨密度分别为0.78±0.11g/cm2、0.50±0.14g/cm2、0.59±0.08g/cm2均低于对照组的0.89±0.06g/cm2、0.62±0.08g/cm2、0.71±0.11g/cm2,具有显著统计学意义(P<0.05),而腰椎骨密度0.83±0.11g/cm2与正常人0.86±0.14g/cm2相比无明显差异(P>0.05)。结论女性绝经合并2型糖尿病患者更易发生骨质疏松,骨折的危险性也高于未合并糖尿病人群,早期筛查血糖及骨密度具有重要意义。

Objective To explore the alteration of bone mineral density （BMD） in postmenopause women combined witli type 2 diabetes. Methods BMD of the lumber vertebra L2-L4 ,left proximal femur including the neck,the Troch and Ward area was measured using dual energy X-ray absorptiometry （ DEXA, Norland, USA） in 58 postmenopausal women cured in our department between 2009 to 2010, of whom 31 without type 2 diabetes and 27 with type 2 diabetes）. Levels of FBG, HbAlc,TG,TC,HDL-C,and LDL-C were measured. Age, course of disease, and time to menopause were also considered. Results The levels of FBG, HbAlc, TG, and LDL-C were 9.71 ±3.36 mmol/L, 8. 19 ± 1.38 mmol/L, 2.25 ± 1.37 mmol/L, and 2.82 ± 0. 86 mmol/L, respectively, in postmenopausal women combined with type 2 diabetes group, that were significantly higher （ P 〈 0. 05） than those in postmenopausal women without type 2 diabetes group （5.60 ± 1.03 mmol/L, 4.55 ±0. 64 mmol/L, 1.31 ±0. 94 mmol/L, 2.26 ± 1. 10 mmol/L, respectively）. The BMDs of the neck, Ward and Troch area in postmenopausal women combined with type 2 diabetes group （0. 78 ±0. 11g/cm2, 0. 50 ± 0. 14 g/cm2, and 0.59 ± 0. 08 g/cm2, respectively） were significantly lower （P 〈0.05） than those in the control group （0. 89 ±0. 06 g/cm2, 0.62 ±0.08 g/cm2, and 0. 71 ±0. 11 g/ cm2, respectively）. The BMD of the lumber vertebra in type 2 diabetes group （0. 83 ± 0. 11 g/cm2） was no difference compared to that in control group （0. 86 ± 0. 14 g/cm2 ）. Conclusion Postmenopausal women combined with type 2 diabetes are more vulnerable to osteoporosis. The fracture risk of these women is higher than that of controls. It is important to measure blood glucose level and BMD in early stage.