血糖控制对2型糖尿病病人骨转换的影响

The influence of glycemic control on bone turnover rate in type 2 diabetes mellitus

目的 探讨血糖控制对 2型糖尿病 (DM)骨转换的影响。方法 测定 43例 2型 DM患者血骨特异性碱性磷酸酶 (BAP)、尿脱氧吡啶酚 (DPD)和血尿钙、磷、镁水平 ,并与正常组比较。结果 2型 DM患者血 BAP、尿 DPD以及钙、磷高于正常对照 ;治疗后 BAP、DPD降低。BAP和 DPD变化水平与糖化血红蛋白、尿糖和尿钙、磷变化水平正相关。结论 控制血糖能使 2型 DM患者骨转换降低。

Objective To investigate whether the good control of fasting plasma glucose(FPG) has any effects on bone turnover rate in type 2 diabetes mellitus (DM).Methods A series of markers,such as bone specific alkaline phosphatase (BAP),deoxypyridinoline (DPD),were assessed before and after glycemic control for more than 18 days in 43 poorly controlled type 2 DM patients with initial hemoglobin A1c over 8%.Results By either oral hypoglycemic agent or insulin administration,or both, ideal control of FPG resulted in a reduction in the secretion of urinary calcium(Ca),phosphate(Pi) and magnesium(Mg),and an increase in serum Ca and Pi without obvious changes in serum Mg.The marker for bone resorption,urinary DPD and the marker for bone formation,BAP in serum were reduced significantly before and after the management.The results indicated that the decreases both in DPD and in BAP were not only correlated well with each other,but with the improvement in glycemic indices as well.Conclusion Good control of hyperglycemia in poorly controlled type 2 DM may have the high bone turnover rate back to normal and protect type 2 DM patients from bone loss.