2型糖尿病与骨质疏松的关系研究

Study on the relationship between type 2 diabetes mellitus and osteoporosis

目的研究2型糖尿病(T2DM)与骨质疏松的关系。方法选取2015年9月~2017年2月在我院接受治疗的T2DM患者96例,以阶段性的血糖控制是否达标作为分组依据,分为血糖控制达标组(n=48)和血糖控制未达标组(n=48),另择选同一时期在我院体检健康者48例,作为对照组。同时,将96例糖尿病(DM)患者以骨质疏松的程度,划分为骨质疏松组(n=37)、正常组(n=13)、和骨密度减低(n=46)三组,对三组25羟维生素D_3(25(OH)D_3、血钙、尿钙、血镁及甲状旁腺激素(PTH)、DM病程及糖化血红蛋白(Hb A1c)指标进行比较分析。结果 (1)血糖控制达标组的25(OH)D_3、血镁低于对照组,尿钙高于对照组,差异均有统计学意义(P<0.05);血糖控制未达标组的25(OH)D_3、碱性磷酸酶(ALP)、血镁低于对照组,尿钙高于对照组,差异均有统计学意义(P<0.05)。(2)骨质疏松组的PTH、DM病程以及Hb A1c高于对照组和骨密度减低组,差异有统计学意义(P<0.05);(3)DM骨密度减低的独立危险因素有PTH、DM病程以及Hb A1c和25(OH)D_3。结论 T2DM与骨质疏松存在明显的相关性;PTH、DM程以及Hb A1c和25(OH)D_3对选取患者的骨密度水平产生影响。

Objective To study the relationship between type 2 diabetes（T2 DM） mellitus and osteoporosis. Methods From September 2015 to February 2017, 96 patients with T2 DM mellitus who were treated in our hospital were divided into two groups： blood glucose control group（n=48） and blood glucose control substandard group（n=48）. In addition, 48 healthy patients in the same period were selected as the control group. At the same time, 96 patients with diabetes mellitus were divided into osteoporosis group（n=37）, normal group（n =13）, and bone mineral density decrease（n =46）according to the degree of osteoporosis three groups were divided into three groups：25（OH）D3（25 hydroxyvitamin D3）,blood calcium, Urine calcium, serum magnesium and PTH（parathyroid hormone）, course of diabetes and Hb A1 c（glycosylated hemoglobin） were compared. Results（1）25（OH）D3 in blood glucose control group was lower than that in control group, serum magnesium was lower than that in control group and the urinary calcium index was higher than that in control group. The differences were statistically significant（P〈0.05）, 25（OH）D3, ALP, serum magnesium in blood glucose control substandard group were lower than those in the control group, and the urinary calcium index was higher than that in the control group. The differences were statistically significant（P〈0.05）.（2） PTH, course of diabetes and Hb A1 c in osteoporosis group were significantly higher than those in control group and BMD decrease, the differences were statistically significant（P〈0.05）.（3）The independent risk factors for the decrease of bone mineral density in diabetes mellitus were significan PTH, the course of diabetes and Hb A1 c and 25（OH）D3. Conclusion There was a significant correlation between T2 DM and osteoporosis. The course of diabetes and the effect of Hb A1 c and 25（OH）D3 on the bone mineral density of type 2 diabetes mellitus.