2型糖尿病合并骨质疏松症患者类胰岛素生长因子-1与骨转换关系研究

Relationship between insulin growth factor-1 levels and bone turnover in the type 2 diabetic patients with osteoporosis

目的 了解 2型糖尿病合并骨质疏松患者其类胰岛素生长因子 - 1(IGF - 1)的变化与骨转换之关系。方法 分别测定 2型糖尿病合并骨质疏松组 (A组 )、2型糖尿病未合并骨质疏松组(B组 )、绝经后骨质疏松组 (C组 )和对照组 (D组 )的血清IGF 1、总碱性磷酸酶 (总AKP)、骨特异碱性磷酸酶 (骨AKP)、骨钙素 (BGP)、尿吡啶啉 (PYD)、尿脱氧吡啶啉 (DPD) ,全段甲状旁腺素 (IPTH) ,并进行组间比较和聚类相关分析。结果 A、C组病例其尿PYD和DPD值明显高于B、D组 ;而IGF 1水平则A、C组明显低于B和D组。聚类相关性分析表明在 2型糖尿病合并骨质疏松组骨密度值与IGF 1关系最为密切 ,而在绝经后骨质疏松组则主要为绝经时间和骨吸收指标 (PYD和DPD)。结论 骨形成减少是 2型糖尿病合并骨质疏松的原因之一 ,而IGF 1的减少可能与

Objective\ To explore the relationship between insulin growth factor 1(IGF 1) and the bone turnover rate in type 2 diabetic(DM) patients with osteoporosis (OP) Methods\ Subjects with or without type 2 diabetes mellitus were divided into four groups;DM with OP,DM without OP,postmenopausal OP and control group.Serum bone specific alkaline,osteocalcin,intact parathyroxine (IPTH),urine pyridinolin(PYD),deoxypyridinoline(DPD) and serum IGF 1 levels were measured.T test was employed to detect the difference between means.The relationship between IGF 1 levels and bone turnover biochemical markers were studied by multiple regression and cluster analysis. Results\ The urine PYD and DPD levels were significantly higher in both osteoporosis groups than in two non osteoporosis groups;whereas the IGF 1 levels were significantly lower in the osteoporosis groups than in the non osteoporosis groups. Conclusion\ Decreased in IGF 1 is related to lower bone formation that may play an important role in pathogenesis of osteoporosis in type 2 diabetic patients.