老年2型糖尿病骨代谢的研究

Research on the Bone Metabolism in the Elderly with Type 2 Diabetes Mellitus

目的 了解老年人 2型糖尿病骨代谢的现状及影响骨代谢的有关因素 ,对 2型糖尿病并发骨质疏松作出早期诊断和治疗。方法 用QCT法分别测定男女糖尿病及非糖尿病患者的骨密度 (BMD) ,用放免法检测骨钙素 (BGP)及Ⅰ型胶原羧基端肽 (ICTP)、甲状旁腺激素 (PTH)等指标。结果 男女糖尿病患者BMD及BGP均低于非糖尿病者 ,而ICTP及PTH均高于非糖尿病者 ,BMD与糖尿病病程、ICTP、PTH、血糖呈显著负相关。结论 糖尿病患者存在BMD显著下降 ,其骨代谢特点是骨吸收增加 ,骨形成降低。血糖控制不良是糖尿病并发骨质疏松的危险因素之一。

Objective To know the status of bone metabolism in the elderly with type 2 diabetes mellitus and its related factors,in order to diagnose and treat type 2 diabetes mellitus complicated with osteoporosis early.Method Bone mineral density(BMD) of diabetes mellitus and non diabetes mellitus in the male and the female was determined with quantitative CT(QCT) technique,bone γ carboxyglutamic protein(BGP),type Ⅰ collagen cross linked telopepatide(ICTP) and parathyroid hormone(PTH) etc. were determined with radio immunity assay.Results Both BMD and BGP in the male and female patients with diabetes mellitus were lower than those in the patients without diabetes mellitus.But ICTP and PTH in the patients with diabetes mellitus were higher than those in the patients without diabetes mellitus.The negative correlation was observed between the BMD and the course of diabetes mellitus,ICTP,PTH,blood sugar.Conclusions BMD in the patients with diabetes mellitus declines significantly.The characters of their bone metabolism are the bone resorption increasing and the bone formation reducing.Failure of blood sugar control is the one of the dangerous factors making the patients with diabetes mellitus suffer from the osteoporosis.