老年男性2型糖尿病患者跟骨超声改变及其与糖化血红蛋白及尿白蛋白排泄率的关系

Observe the ultrasound changes of calcaneus and analysis the relationship with HbA_(lc) and urinary albumin excretion in elderly patients with type 2 diabetes

目的观察老年男性2型糖尿病患者跟骨定量超声测量(QUS)的变化及其与血糖水平、糖化血红蛋白(HbA_(1c))、尿白蛋白排泄率(UAE)变化的关系。方法老年男性2型糖尿病患者79例为糖尿病组,HbA_(1c)<7%者为Ⅰ组,若UAE<30mg/24h为ⅠA组,UAE>30mg/24h为ⅠB组;HbA1。>7%者为Ⅱ组,若UAE<30mg/24h为ⅡA组,UAE>30mg/24h为ⅡB组。健康体检无糖尿病男性43例为健康对照组。分别测定血糖、HbA_(1c)、ALP、Cr、UAE,采用超声骨密度仪对患者右跟骨进行检测,测量超声振幅衰减平均值(BUA)、超声传播速度(SOS),并计算骨硬度指数(STI)。结果糖尿病组与健康对照组相比,BUA、SOS、STI显著降低(P<0.01),糖尿病组ⅡIB组BUA、SOS、STI明显低于ⅡA组、ⅠA组、ⅠB组(P<0.05)。2组BMI及生化指标差异无统计学意义(P>0.05)。结论糖尿病患者BUA、SOS、STI均较健康者显著降低,血糖控制不达标且微量白蛋白尿>30 mg/24h患者下降较血糖控制达标且微量白蛋白尿<30 mg/24h患者更为显著。

Objective To observe quantitative ultrasound（QUS） changes in elderly male patients with type 2 diabetes,and investigate the relationship with blood glucose level,HbA_（1c） and urinary albumin excretion（UAE）. Methods There were 79 elderly male patients with type 2 diabetes in the study group,43 patients without diabetes in the control group.Patients with diabetes were divided into four subgroup：Group I：HbA_（1c）7%,Group IA;UAE30 mg/24 h,Group IB：UAE30 mg/24 h,Group II：HbA_（1c）.7%,Group IIA：UAE30 mg/24 h and Group IIB：UAE30 mg/24 h.Glucose,HbA_（1c）,ALP,Cr,UAE,BUA,SOS and STI were measured.Results Compared with control group,BUA,SOS and STI in diabetic group decreased significantly（P0.01）.BUA,SOS and STI in diabetes subgroup of IIB was significandy lower than in subgroup IIA,subgroup IA and group IB（P0.05）.Conclusion The BUA,SOS,STI are lower in diabetic group than in controls group.The BUA,SOS and STI of patients with abnormal blood glucose and microalbuminuria30 mg/24 h are decreased more significantly than those with normal blood glucose and microalbuminuria30 mg/24h.