绝经后2型糖尿病女性雌激素水平与骨质疏松的相关性研究

Study of the Relationship Between Estrogen and Osteoporosis Among Postmenopausal Women with Type 2 Diabetes Mellitus

【目的】探讨绝经后2型糖尿病（T2DM）合并骨质疏松（OP）妇女雌激素水平及骨密度的变化及其相关性。【方法】120例绝经后女性T2DM患者根据骨密度值分为骨密度正常组即T组（62例），骨质疏松组即P组（58例）。另选取60例血糖及骨密度均正常的绝经后女性作为正常对照组，即N组（60例）。比较三组骨代谢、糖代谢及性激素等指标。【结果】P组骨碱性磷酸酶（sBAP）、骨钙素（sOC）、Ⅰ型胶原交联C 端肽（sCTx）和尿Ⅰ型胶原交联N 端肽（uNTx）明显低于T组。P组与T组、N组比较，血清卵泡刺激素（FSH）、促黄体激素（LH）升高，雌二醇（E2）下降（ P＜0．05）。相关性分析显示，患者O P与糖尿病病程、年龄、糖化血红蛋白（HbA1C）、空腹血糖（FPG）、FSH、LH、uNTx与肌酐（Cr）呈显著负相关，与sBAP、sOC、sCTx无相关性。【结论】绝经后T2DM妇女骨质疏松与糖代谢及雌激素水平有关。

[Objective]To explore the changes of estrogen level and bone density among postmenopausal women with type 2 diabetes mellitus（T2DM ） and osteoporosis （OP） and their correlation .[Methods] Postmenopausal women were divided into T2DM group（group T ,n=62） ,T2DM with osteoporosis group（group P , n =58） and normal control group（group N ,n=60） .Bone metabolism ,glucose metabolism ,sex hormone and other indicators among three groups were compared .[Results]Bone alkaline phosphatase（sBAP） ,osteocalcin （sOC） ,type I collagen cross-linked C end peptide（sCTx） and urine type I collagen cross-linked N end peptide （uNTx） of group P were obviously lower than those of group T .Compared with group T and group N ,serum FSH and LH were elevated ,but E2 was decreased in group P（ P 〈0 .05） .Correlation analysis showed that bone mineral density （BMD） had significantly negative correlation with the duration of diabetes ,age ,HbA1C , FPG ,FSH ,LH and uNTx/Cr ,but no correlation with sBAP ,sOC and sCTx .[Conclusion]Osteoporosis of postmenopausal women with T2DM is related to glucose metabolism and estrogen level .