绝经后女性2型糖尿病患者骨密度及骨标志物水平研究

Bone mineral density and bone biomarkers in post-menopausal women with type 2 diabetes

目的探讨绝经后女性2型糖尿病患者的骨密度及骨标志物水平。方法选择2014年12月~2016年3月在309医院骨内科住院的绝经后女性患者128例,其中2型糖尿病者60例为研究组,年龄50-69岁,平均年龄60.8岁,无糖尿病者68例为对照组,年龄50-69岁,平均年龄59.8岁,采用美国好乐杰公司双光能骨密度仪测量所有患者腰椎L2-L4和左侧股骨近端及全髋骨密度,并测定其身高、体重、体重指数(BMI),记录其入院时生化指标如血脂,血钙、磷、镁、空腹血糖情况,采用酶联免疫吸附法测定各组的B-ALP、CTX、PINP、25羟维生素D的水平,比较两组间骨密度值、生化指标及骨标志物水平是否存在统计学差异。结果两组间一般情况如年龄、身高、体重、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血镁、血脂水平无统计学差异,两组髋部及腰1-4椎体骨密度水平、25羟维生素D及PTH无统计学差异。观察组空腹血糖、血钙水平、骨代谢标志物CTX高于对照组,而OC、ALP低于对照组,差异具有统计学意义。结论绝经后2型糖尿病妇女骨转换标志物异常,可能是预测糖尿病性骨质疏松的一个标志。

Objective To investigate the levels of bone mineral density and bone biomarkers in postmenopausal women with type2 diabetes mellitus.Methods In total 128 cases of postmenopausal women presented to the 309 Hospital Bone Medical Department between December 2014 to March 2016 were studied,including 60 patients with type 2 diabetes,age 50-69（average 60.8） years,and 68 cases without diabetes,aged 50-69（average 59.8） years.All were measured for lumbar L2-L4 and left hip bone mineral density using a HOLOGIC dual-energy bone densitometer.Other measures include patients’ height,weight,body mass index（BMI）,records on admission,biochemical measures of blood lipids,blood calcium,phosphorus,magnesium,fasting glucose,and enzyme4 inked immunosorbent determination of B-ALP,CTX,PINP and 25 hydroxy vitamin D levels.Comparisons were made between the two groups on bone mineral density and bone biomarkers.Results Between the two groups,there were no significant differences in age,height,weight,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,blood magnesium and blood lipid levels.Hip and lumbar spine bone mineral density,and 25 hydroxy vitamin D and PTH levels between the two groups were also not significantly different.Fasting blood glucose,blood calcium levels and bone metabolic markers CTX of the observation group was higher,and OC and ALP levels were lower than the control group,the differences were statistically significant.Conclusion Bone turnover markers in postmenopausal women with type 2 diabetes were abnormal,and could be a predictor of diabetic osteoporosis.