定量CT评估1型糖尿病患者股骨骨密度和骨强度

Evaluation of Bone Mineral Density （BMD） and Bone Strength of Femoral Bone in Patients with Type 1 Diabetes Mellitus under Quantitative CT

【目的】采用定量CT评估1型糖尿病患者股骨骨密度和骨强度,并探讨其与胰岛素样生长因子-1（IGF-1）的相关性。【方法】选择本院收治的25例1型糖尿病患者为观察组,选择同期在本院健康体检的25例健康者为对照组。通过三维定量CT计算股骨不同部位体积骨密度（vBMD）和骨强度,检测血清IGF-1、骨特异性碱性磷酸酶（B-ALP）、骨钙素（sOC）、Ⅰ型前胶原氨基端肽（PⅠNP）,分析1型糖尿病患者股骨骨密度和骨强度与IGF-1之间的相关性。【结果】与对照组比较,观察组股骨颈皮质vBMD明显降低[（582.5±27.7） mg/cm3 vs （558.1± 31.9） mg/cm3,P〈0.05];股骨粗隆总vBMD、皮质厚度和皮质横截面积显著降低[（258.4 ± 42.9） mg/cm3 vs（223.7± 27.3）mg/cm3;（3.3 ± 0.7）mm vs（2.8 ± 0.5）mm;（5.3 ± 1.2）cm2 vs （4.3 ± 0.5）cm2;均P〈0.01]。与对照组比较,观察组屈曲比（BR）显著增加[（10.8 ±1.8） vs（12.9±1.9）, P〈0.01]。观察组和对照组血清B-ALP、sOC、PⅠNP水平比较,差异无统计学差异（P〉0.05）。血清IGF-1与1型糖尿病患者股骨颈总vBMD呈显著正相关性（r=0.48;P〈0.05）。【结论】定量CT发现1型糖尿病患者股骨粗隆间vBMD、皮质横截面积和皮质厚度较低,血清IGF-1水平可显著影响1型糖尿病患者股骨颈总vBMD。

【Objective】To evaluate the bone mineral density （BMD） and bone strength of femoral bone in patients with type 1 diabetes mellitus by quantitative CT, and the relationship with insulin-like growth factor -1 （IGF-1）.【Methods】Twenty-five patients with type 1 diabetes mellitus in our hospital were selected as observation group, and 25 healthy subjects in the same period of time in our hospital were selected as control group.Through the three-dimensional quantitative CT, volumetric bone mineral density （vBMD） and bone strength , serum IGF-1, bone alkaline phosphatase （B-ALP）, osteocalcin （sOC） and procollagen amino terminal peptide （P I NP） at different parts of femoral bone were calculated ,and the correlation between bone mineral density and bone strength of femoral bone and IGF-1 of type I diabetes mellitus patients were analyzed .【Results】Compared with the control group, the femoral neck cortex vBMD of the observation group was significantly reduced [（582.5 ± 27.7） mg/cm3 vs （558.1± 31.9） mg/cm3,P〈0.05];The total vBMD, cortical thickness and cortical cross-sectional area were significantly lower [（258.4 ± 42.9） mg/cm3 vs（223.7± 27.3）mg/cm3;（3.3 ± 0.7）mm vs（2.8 ± 0.5）mm;（5.3 ± 1.2）cm2 vs （4.3 ± 0.5）cm2;mean P〈0.01]. Compared with the control group, the BR of the observation group was significantly increased[（10.8 ±1.8） vs（12.9±1.9）,P〈0.01]; The serum levels of B-ALP, sOC, P I and NP in the observation group and the control group had no significant difference （P〉0.05）.There was a significant positive correlation between serum IGF-1 and total vBMD of femoral neck in patients with type 1 diabetes mellitus （r=0.48; P〈0.05）.【Conclusion】Quantitative CT revealed that vBMD, cortical cross-sectional area and cortical thickness were lower in patients with type 1 diabetes. Serum IGF-1 level can significantly affect the total vBMD of femoral neck in patients with type 1 diabetes mellitus.