噻唑烷二酮类降糖药物对2型糖尿病患者骨骼的影响

Effect of thiazolidinedione hypoglycemic agent on skeleton of type 2 diabetes patients

目的探讨噻唑烷二酮类药物对2型糖尿病患者骨骼的影响。方法 59例2型糖尿病患者出院方案有吡格列酮(噻唑烷二酮类药物)作为研究组,另选取同期36例2型糖尿病患者出院口服药物降糖方案不含吡格列酮(噻唑烷二酮类药物)作为对照组,分析两组骨折、骨痛发生情况。结果研究组发生严重摔伤后骨折患者2例(均为女性),发生率为3.39%;既往无骨痛现出现骨痛患者12例(其中女7例,男5例),发生率为20.34%;无明显骨骼系统症状不适患者45例(76.27%)。对照组无骨折发生情况,仅有1例骨痛患者,发生率为2.78%。研究组骨痛发生率高于对照组,差异具有统计学意义(P<0.05)。结论对绝经后女性、老年人等存在骨折高危风险的糖尿病患者,在使用噻唑烷二酮类药物时应全面评估其骨代谢情况,关注骨密度,预防骨折和骨质疏松的发生。

Objective To observe influence of thiazolidinedione hypoglycemic agent on skeleton of type 2 diabetes patients. Methods A total of 59 cases of type 2 diabetes patients with pioglitazone（thiazolidinedionehypoglycemic agent） in discharge solution as research group, and concurrent 36 cases of type 2 diabetes patients without pioglitazone（thiazolidinedione hypoglycemic agent） in discharge solution of reducing blood glucose as control group. Fracture and bone pain rate were surveyed in two groups. Results The research group had 2 fracture cases（both were female） caused by serious fall, accounted for 3.39%, 12 bone pain cases（7 female cases and 5 male cases） without bone pain history, accounted for 20.34%, and 45 cases without clear skeletal system discomfort（accounted for 76.27%）. The control group had 0 fracture case and 1 bone pain case, accounted for 2.78%. The research group had higher incidence of bone pain than the control group, and the difference had statistical significance（P〈0.05）. Conclusion For diabetic patients with high risk of fracture such as postmenopausal women and the elderly, bone metabolism should be thoroughly evaluated when it comes to thiazolidinedione hypoglycemic agent, and more attention should be payed to bone mineral density to prevention fracture and osteoporosis.