2型糖尿病患者HbA1C、25(OH)VD水平与骨密度的相关性研究

The relationships between HbA1c,25(OH) VD level,and BMD in type 2 diabetes patients

目的观察2型糖尿病患者HbA1C、25(OH)VD水平与骨密度(Bone Mineral Density,BMD)的相关性。方法收集我院160例住院患者资料,以HbA1C水平分组,HbA1C<7%为组1(平均年龄52.47±11.39岁),HbA1C>8.5%为组2(平均年龄56.38±9.84岁),测定HbA1c、身高、体重、体重指数(Body Mass Index,BMI),采用美国Norland双能X线骨密度检测仪测定患者L2-4和左侧股骨近端(Neck、Troch、Ward’s三角区)BMD,采用酶联免疫吸附法检测血清25(OH)VD,分析HbA1c、25(OH)VD、BMD三者的相关性。结果两组患者身高、体重、BMI无显著性差异,2型糖尿病患者血清25(OH)VD水平与HbA1C呈负相关(r=-0.758,P<0.05),与腰椎骨密度无相关性(P>0.05),与髋部骨密度呈明显正相关(P<0.05)。结论糖尿病患者血糖控制水平对25(OH)VD与骨密度有不良影响。

Objective To observe the relationships between HbAlc, 25 （OH） VD, and bone mineral density （BMD） in type 2 diabetic patients. Methods 160 type 2 diabetic patients were enrolled in the study in 309 Hospital of PLA. They were grouped according to the level of HbAlc. The patients with the HbAlc concentration lower than 7% were chosen as group 1 （average age 52.47 -＋ 11.39 years old）. The patients with HbA1 C concentration higher than 8.5% as group 2 （ average age of 56.38 -＋ 9.84 years old）. The concentration of HbAlc, height, weight, and BMI were measured. BMDs of L2~, and the left femur （neck, troch, and Ward＇ s） were measured using dual energy X-ray absorptiometry （DEXA）. The concentration of 25-（OH） VD was measured with enzyme linked immunosorbent assay. The relationships among HbAlc, BMD, and 25 （OH） VD were analyzed. Result The differences of height, weight, and BMI of patients in two groups were not significant. The concentration of serum 25-（OH） VD was negatively associated with HbA1C in the type 2 diabetic patients （ r = 0. 758, P 〈 0. 05 ）. The concentration of serum 25-（OH） VD was not associated with BMD of lumber vertebra （P 〉 0. 05 ）. The concentration of serum 25- （OH） VD was positively associated with BMD of the hip （P 〈 0. 05 ）. Conclusion The controlled level of glucose in diabetic patients has undesirable effect on 25-（OH） VD and BMD.