老年男性2型糖尿病患者骨密度变化与血糖的相关性

Correlation between bone mineral density and plasma glucose in senile male patients with type 2 diabetes

目的分析老年男性2型糖尿病骨密度(BMD)变化与空腹血糖(FPG)和糖化血红蛋白(HbAlc)的关系。方法用美国GE Lunar公司生产的Prodigy型双能X线吸收仪(Dual-energy X-ray Absorptiometry,DXA),测定60例70岁以上2型糖尿病(diabetes mellitus T2 DM)患者正位腰椎(L1-L4)骨密度及左侧股骨颈部骨密度,同时检测FPG和HbAlc,并以相同的测量方法对60例70岁以上血糖正常老年男性作配对为对照组,对二部位BMD值、FPG和HbAlc进行回顾性统计分析。结果 2型糖尿病组与非糖尿病组(对照组)腰椎BMD比较无统计学意义(P>0.05),而股骨颈部BMD、FPG和HbAlc比较均有显著性差异(P<0.01)。结论 FPG和HbAlc值越高其股骨颈部BMD值越低。患者代谢控制不良会造成骨量丢失加速,易发骨质疏松。

Objective To analyze the relationship among bone mineral density （BMD） , fasting plasma glucose （FPG） , and HbAlc in senile male patients with type 2 diabetes. Methods Sixty male patients with type 2 diabetes, who were over 70 years old, were selected. BMD of the lumbar vertebrae （L1-4） and the left femoral neck was detected using dual-energy X-ray absorptiometry （Prodigy, GE Lunar Co. , USA）. Meanwhile, FPG and HbAlc were detected. Sixty healthy senile males were selected as control group. And the same method was used to obtain the data mentioned above. Then the data of BMD, FPG, and HbAlc in 2 groups were retrospectively analyzed. Results BMD of the lumbar vertebrae in diabetes group was not significantly different to that in control group （P 〉0. 05） , while the BMD of the femoral neck, FPG, and HbAlc in diabetes group were significantly different to those in control group （P 〈 0.01 ）. Conclusion The higher the values of FPG and HbAlc are, the lower the BMD of the femoral neck is. It reveals that poor control of glucose metabolism leads to an accelerated loss of the bone mass, which is susceptible to osteoporosis. For senile male patients with type 2 diabetes, other than controlling the plasma glucose, early detection of BMD should be performed, and the bone mass loss in the femoral neck should be paid more attention, which is in favor of early diagnosis and early treatment, thus preventing the occurrence of osteoporotic fractures.