阿伦膦酸钠对老年女性2型糖尿病骨质疏松患者骨代谢标志物的影响

Effects of alendronate on bone matebolic markers in type 2 diabetic elderly women patients with osteoporosis

目的观察老年女性2型糖尿病(T2DM)骨质疏松患者应用阿伦膦酸钠(ALN)联合钙尔奇D治疗后骨密度(BMD)和骨代谢指标的变化。方法采用双能X线骨密度仪(DEXA)对34例老年女性糖尿病骨质疏松患者给予ALN联合钙尔奇D治疗6个月,对比治疗前后腰椎和髋部BMD及骨代谢标志物的变化。结果 ALN联合钙尔奇D治疗6个月后腰椎和髋部T值和BMD均增加,尤其L1、L3、L4及L总部位增加显著;血清抗酒石酸酸性磷酸酶5b、尿羟脯氨酸/肌酐比值和骨碱性磷酸酶水平较治疗前降低,血清降钙素水平较治疗前升高(P均<0.05)。结论 ALN联合钙尔奇D治疗老年女性T2DM患者骨质疏松疗效明显,短时间内可显著改善骨代谢指标和提高腰椎BMD。

Objective To observe the changes of bone mineral density（BMD） and bone metabolic markers in type 2 diabetic（T2DM） elderly women patients with osteoporosis treated by alendronate（ALN） plus caltrate.Methods Thirty-four T2DM elderly women patients with osteoporosis were treated by ALN plus caltrate for 6 months.To compare the changes of BMD（lumbar spine and hip） and bone metabolic markers before and after treatment.Results T values and BMD at the lumbar spine and hip increased after treatment,especially in L1,L3,L4 and Ltotal parts.The levels of serum TRAP-5b,urinary HOP/Cr ratio and B-AKP were significantly lower and the level of serum calcitonin was significantly higher（P0.05）.Conclusion ALN plus caltrate had a good effect to treat osteoporosis of T2DM elderly women patients,which could improve the bone metabolic markers and increase BMD in lumbar spine.