老年男性骨质疏松合并2型糖尿病患者血清25羟维生素D水平研究

Study of serum 25-OH vitamin D level in senile male patients with osteoporosis and type 2 diabetes

目的探讨老年男性骨质疏松合并2型糖尿病患者血清25羟维生素D的水平。方法选择2011年3月至2014年5月我科住院的54例患者,包括老年男性骨质疏松合并2型糖尿病患者27例,年龄70.78±7.30岁,非糖尿病老年男性骨质疏松患者27例,年龄71.44±6.38岁。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)、血谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(CRE)、尿素氮(BUN)。采用酶联免疫吸附法测定两组患者血清25羟维生素D,比较两组25羟维生素D水平。结果老年男性骨质疏松合并2型糖尿病患者血清25羟维生素D14.38±3.00ng/ml,较非糖尿病老年男性骨质疏松患者25羟维生素D19.53±8.96ng/ml低,差异具有统计学意义(P<0.05);老年男性骨质疏松合并2型糖尿病患者ALT22.76±11.73 IU/L、AST 20.16±7.65IU/L、CRE 77.48±20.29 umol/L、BUN 6.38±1.84 mmol/L与非糖尿病骨质疏松患者ALT 18.26±7.53 IU/L、AST 19.33±5.83 IU/L、CRE 77.11±15.16 umol/L、BUN 6.32±2.19 mmol/L相比,差异无统计学意义(P>0.05);老年骨质疏松合并2型糖尿病患者L2-4、L2、L3、L4、Neck、Troch、ward’s三角区的骨密度分别为1.01±0.20 g/cm2、0.98±0.20 g/cm2、1.01±0.21 g/cm2、1.02±0.21 g/cm2、0.82±0.25 g/cm2、0.77±0.20 g/cm2、0.65±0.281 g/cm2与对照组0.96±0.19 g/cm2、0.92±0.19 g/cm2、0.95±0.19 g/cm2、1.00±0.22 g/cm2、0.75±0.18 g/cm2、0.64±0.13 g/cm2、0.58±0.19 g/cm2相比较,差异没有统计学意义(P>0.05)。结论老年男性骨质疏松合并2型糖尿病患者较非糖尿病骨质疏松患者维生素D缺乏更严重。

Objective To investigate the serum level of 25-OH vitamin D in senile male patients with osteoporosis and type 2 diabetes.Methods Fifty-four senile male patients, who were hospitalized in our department from March 2011 to May 2014, were selected.Among all these patients, 27 senile osteoporosis patients with type 2 diabetes were included, with an average age of 70.78 ±7.30 years old.The other 27 senile osteoporosis patients without type 2 diabetes were also included, with an average of 71.44 ±6.38 years old.The bone mineral density （ BMD） of L2-L4 and the left proximal femur, including the Neck, the Troch, and the Ward’ s triangle, was detected using dual energy X-ray absorptiometry （ DEXA, Norland Co., USA） .The height, weight, FBG, ALT, AST, CRE, and BUN in the 2 groups were also detected.The serum 25-OH vitamin D was detected using enzyme linked immunosorbent assay, and the levels of 25-OH vitamin D between the 2 groups were compared.Results The serum level of 25-OH vitamin D in senile male patients with osteoporosis and type 2 diabetes was 14.38 ±3.00ng/ml, which was significantly lower than that in senile male osteoporosis patients without type 2 diabetes （19.53 ±8.96ng/ml; P〈0.05）.The serum levels of ALT, AST, CRE, and BUN in senile male osteoporosis patients with type 2 diabetes were 22.76±11.73 IU/L, 20.16±7.65 IU/L,77.48 ±20.29 umol/L, and 6.38 ±1.84 m mol/L, respectively, which showed no significant difference with those in senile male osteoporosis without type 2 diabetes （18.26 ±7.53 IU/L, 19.33±5.83 IU/L, 77.11±15.16 umol/L, and 6.32 ±2.19 mmol/L, respectively;P〈0.05）.BMD of L2-4, L2, L3, L4, the Neck, the Troch, and the Ward’s triangle in senile male osteoporosis patients with type 2 diabetes was 1.01±0.20 g/cm2 , 0.98 ±0.20 g/cm2 , 1.01 ±0.21 g/cm2 , 1.02 ±0.21 g/cm2 , 0.82 ±0.25 g/cm2 , 0.77 ±0.20 g/cm2 , and 0.65 ±0.281 g/cm2 , respectively, which also showed no significant difference with those in senile male osteoporosis patients without type 2 diabetes （ 0.96 ±0.19 g/cm2 , 0.92±0.19 g/cm2 , 0.95 ±0.19 g/cm2 , 1.00 ±0.22 g/cm2, 0.75 ±0.18 g/cm2, 0.64±0.13 g/cm2, and 0.58±0.19 g/cm2, respectively;P〉0.05）.Conclusion Vitamin D deficiency in senile male osteoporosis patients with type 2 diabetes is more serious than that in senile male osteoporosis patients without type 2 diabetes.