男性2型糖尿病患者25羟维生素D_3及骨代谢指标的变化分析

Relation of 25-hydroxy vitamin D_3,bone metabolism index in male Patients with tyPe 2 diabetes

目的：了解男性2型糖尿病患者25羟维生素D3和骨代谢指标的变化及与骨密度的相关性。方法男性2型糖尿病住院患者160例，年龄≥40岁；测定骨密度值，依据骨密度分三组：骨量正常组52例，骨量减组52例，骨质疏松组56例；非糖尿病骨量正常对照组46例；对其年龄、BMI、25-OHD、PTH、PINP、β-CTX、ALP、血Ca、血P进行方差分析，分析25-OHD及PTH、PINP、β-CTX、ALP与各部位骨密度的相关性，并分析25-OHD与PTH、PINP、β-CTX、ALP的相关性。结果4组之间年龄差异无统计学意义；BMI、25-OHD、PINP、β-CTX、ALP的差异均有统计学意义；血钙、血磷的差异均无统计学意义。25羟维生素D3与股骨颈呈正相关（P＜0．05），与股骨全部、腰椎L2～4呈正相关（P＜0．01）；I型前胶原氨基末端前肽（PINP）、β-胶原降解产物（β-CTX）、ALP与股骨颈、股骨全部及腰椎L2～4呈负相关（P均＜0．01）；PTH与股骨颈、股骨全部呈负相关（P＜0．05），与腰椎呈负相关（P＜0．01）。25羟维生素D3与β-CTX、PTH无明显相关（P＞0．05），与ALP呈负相关（P＜0．01），与PINP呈负相关（P＜0．05）。结论2型糖尿病患者25羟维生素D3水平明显低于非糖尿病者，且与骨密度呈正相关，与ALP、PINP呈负相关。男性2型糖尿病患血清PTH、I型前胶原氨基末端前肽（ PINP）、β-胶原降解产物（β-CTX）、ALP与骨密度负相关。

Objective To investigate the change of vitamins and bone metabolism index and the correlation with bone density in male Patients with tyPe 2 diabetes.Methods A hundred and sixty cases of Patients with tyPe 2 diabetes in hosPital were collected.The ages of Patients are beyond their 40.When determination of bone mineral density value was made, the Patients were assigned into three grouPs on the basis of bone mineral density：52 cases of normal bone mass,52 cases of decreased bone mass,56 cases of osteoPorosis grouP.Forty-six cases of normal were chosen as control grouP.One-way ANOVA statistics analysis was made of their age,BMI,25-OHD,PTH,PINP,β-CTX,ALP,blood Ca,and blood P.The correlation between bone mineral density of different Parts and 25 OHD and PTH,PINP,β-CTX,ALP,the correlation between 25-OHD and the PTH,PINP,β-CTX,and ALP were analyzed.Results There was no statistically significant difference among 4 grouPs in age.There were significant differences in BMI,25 OHD,PINP,β-CTX,PTH,ALP, while there were no significant differences in blood calcium and blood PhosPhorus.There was Positively correlation between 25 hydroxy vitamin D3 and femoral neck （P〈0.05）,and 25 hydroxy vitamin D3 was Positively correlated with the femur and umbar L2~L4 （P〈0.01）.PINP,β-CTX,ALP were negatively correlated with femoral neck,the femur and umbar L2~L4 （P〈0.01）.PTH was negatively correlated with femoral neck and the femur（P〈0.05）,and was negatively correlated with lumbar L2~L4 （P〈0.01）.25 hydroxy vi-tamin D3 was not correlated withβ-CTX and PTH （P〉0.05）,but was negatively correlated with ALP （P〈0.01）,and with PINP （P〈0.05）.Conclusions Level of 25-hydroxy vitamin D3in Patients with tyPe 2 diabetes was lower than that in those without diabetes, which was Positively correlated with bone mineral density,and negatively correlated with ALP,PINP.Serum PTH,tyPe I collagen amino terminal before the PePtide （ PINP） ,collagen degradation Products,β-CTX and ALP of male Patients with tyPe 2 diabetes is negatively related to the bone density.