阿伦磷酸钠对绝经后2型糖尿病合并骨质疏松症患者骨代谢的影响

Effect of alendronate on bone metabolism in postmenopausal women with type 2 diabetes and osteoporosis

目的探讨阿伦膦酸钠对绝经后2型糖尿病合并骨质疏松症患者骨代谢及骨密度的影响。方法选择2012年1月至2013年1月在本院接受治疗的绝经后2型糖尿病合并骨质疏松症患者51例,给予阿伦膦酸钠治疗6个月。采用美国Norland双光能X线骨密度检测仪对所有患者进行腰椎L2-L4和左侧股骨近端(包括Neck、Troch、Ward三角区)骨密度测量,并测定身高、体重、空腹血糖(FBG)、HbAlc、PTH、OC、CTX、25(OH)VD、BALP等。对比治疗前后骨密度及骨代谢标志物变化。结果用阿伦膦酸钠治疗6个月使绝经后2型糖尿病合并骨质疏松症患者的FBG、2hPG、HbA1c降低,治疗前与治疗后相比较,差异有统计学意义(P〈0.05)。血Ca、P浓度治疗前与治疗后相比较,差异无统计学意义(P>0.05)。骨代谢标志物CTX治疗前与治疗后相比,差异有统计学意义(P〈0.05)。OC、PTH、BALP、25OHVD治疗前与治疗后相比较,差异无统计学意义(P>0.05)。治疗前腰椎和股骨颈骨密度与治疗后相比较,差异有统计学意义(P〈0.05)。Torch、Ward部位骨密度治疗前与治疗后相比较,差异没有统计学意义(P>0.05)。结论阿伦膦酸钠治疗绝经后2型糖尿病合并骨质疏松症疗效明显,短时间内可改善骨代谢指标和提高腰椎骨密度。

Objective To investigate the effect of alendronate on bone metabolism and bone mineral density （BMD） in postmenopausal women with type 2 diabetes and osteoporosis. Methods Fifty-one postmenopausal women with type 2 diabetes and osteoporosis, who received treatment in our hospital from Janaury 2012 to Janaury 2013, were selected. All the patients were treated with alendronate for 6 months. BMD of L2 - L4 and the left proximal femur （including the neck, the Torch, and the Ward＇ s triangle） was detected using dual energy X-ray absorptiometry （DEXA, Norland, USA）. The height, weight, FBG, HbAlc, PTH, OC, CTX, 25（OH） VD, and BALP were also detected. The changes of BMD and bone metabolic markers before and after treatment were compared. Results In these postmenopausal women with type 2 diabetes and osteoporosis, after 6-month alendronatc treatment, FBG, 2hPG and HbAle were significantly lower than those before the treatment （P 〈 0.05）. The serum levels of Ca and P before the treatment had no significant difference with that after the treatment（ P 〉 0.05 ）. The serum CTX level after the treatment was significant lower than that before the treatment（P 〈 0.05）. The serum levels of OC, PTH, BALP, and 25OHVD after the treatment had no significant difference with those before the treatment（ P 〉 0.05）. BMD of L2, L3, IA, L2 - 4, the femoral neck after the treatment were significantly higher than that before the treatment（ P 〈0. 05 ）. BMD of the Torch and the Ward triangle after the treatment had no significant difference with that before the treatment （P 〉 0.05 ）. Conclusion The efficacy of alendronate on osteoporosis in nostmenooausal with tvoe 2 diabetes is obvious, which can imorove the bone metabolic markers and BMD in a short time.