肥胖对2型糖尿病患者骨密度的影响及药物干预疗效观察

Influence of obesity on bone mineral density of patients with type 2 diabetes and melbine effect

目的探究肥胖对2型糖尿病患者骨密度(BMD)的影响,以及二甲双胍对糖尿病性BMD及体重指数(BMI)的影响。方法:对150例2型糖尿病患者根据其BMI分为两组:肥胖组(n=75,BMI>28)和正常组(n=75,23.9>BMI>18.5),两组均给予二甲双胍治疗。结果:两组治疗前的空腹血糖(f FBG)及糖化血红蛋白(Human HbA1C)无统计学差异(P>0.05),与正常组比,肥胖组的BMI较高(P<0.05),治疗后,两组的FBG、HbA1C均明显降低,两组无统计学差异(P>0.05),肥胖组的BMI明显降低(P<0.05),正常组BMI无变化(P>0.05)。治疗前,除手臂BMD,肥胖组的腿部、躯干和全身BMD均明显降低(P<0.05),治疗后,正常组BMD无统计学变化(P>0.05),肥胖组的腿部、躯干和全身BMD均明显增高(P<0.05),两组BMD无统计学变化(P>0.05)。结论:肥胖2型糖尿病可伴不同程度地BMD降低。对肥胖2型糖尿病患者,二甲双胍不仅可以控制血糖水平,而且还可降低BMI和提高BMD,肥胖2型糖尿病患者自二甲双胍的受益明显高于正常组。

Objective： To evaluate the effect of obesity on bone mineral density of patients with type 2 diabetes,and the effect of metformine on diabetic osteoporosis.Methods： A total of 150 patients with type 2 diabetes were assigned to obesity group （n = 75,BMI〉28） and normal group （n = 75,23.9〉BMI〉18.5） according to their body mass index （BMI） ： all used metformin for 1 year.Results： There were no significant differences in fasting blood glucose （FBG） and human haemolysate glycated haemoglobin （HbA1C） between two groups （P〉0.05）.Compared with the normal group,the BMI of the obesity group was higher （P〈0.05）.After treatment,the levels of FBG and HbA1C in two groups were significantly lower than those before treatment （P〉0.05）.The BMI of the obesity group was significantly lower than that before treatment （P〈0.05）.After treatment,the BMD of the normal group was not statistically changed （P〉0.05）.The BMD of the legs and torso of the obesity group was significantly higher than that before treatment （P〈0.05）.Conclusion： Obese type 2 diabetes mellitus may be associated with different degree of BMD reduction.For obese patients with type 2 diabetes,not only dose metformin control blood glucose levels,but also reduces BMI and increases BMD,and obesity patients with type 2 diabetes benefits significantly from metformin than the normal BMI patients with type 2 diabetes.