胰岛素样生长因子-Ⅰ与老年男性2型糖尿病患者骨密度变化的关系

Changes of bone mineral density and insulin-like growth factor-Ⅰin male aged type 2 diabetic patients

目的 探讨胰岛素样生长因子 Ⅰ (IGF Ⅰ )与老年男性 2型糖尿病患者骨密度变化的关系。方法 选择 60岁以上男性 2型糖尿病患者 3 2例 ,用双能X线骨密度仪测量其骨密度(BMD) ,并测定血IGF Ⅰ及参与骨代谢有关的激素和生化指标 ,并与正常老年男性对照。结果 糖尿病组与对照组比较 ,BMD、IGF Ⅰ、血睾酮 (T)显著降低 ;生长激素 (GH )升高。IGF Ⅰ、T水平与BMD有显著相关性 (P <0 .0 5 )。糖尿病患者糖化血红蛋白 (HbA1c)、T与血清IGF Ⅰ显著相关(P <0 .0 5 ) ;IGF Ⅰ (P <0 .0 1)、空腹C肽 (FCP) (P <0 .0 1)、T(P <0 .0 5 )与糖尿病组BMD均显著相关。结论 IGF Ⅰ的减少可能是 2型老年男性糖尿病患者合并骨质疏松的原因之一。

Objective To investigate the relationship between insulin like growth factor Ⅰand changes of bone mineral density in male aged type 2 diabetic patients.Methods The forearm bone mineral densities in 32 male patients with type 2(non insulin dependent) diabetes and 32 male common controls were measured by dual energy X ray absorptiometry (DEXA).In addition, markers of bone metabolism related factors [ plasma insulin like growth factor Ⅰ(IGF Ⅰ), growth hormne(GH),testosterone(T),fasting C peptide (FCP)]were measured in the diabetic patients.Results Compared with control group,the BMD,IGF Ⅰ,and T levels signifcantly decreased in aged diabetic group;in contrast,GH increased.There was a positive correlation between IGF Ⅰ,T and BMD in both groups ( P <0.05) ,There was a positive correlation between HbA1c,T and IGF Ⅰin diabetic group( P <0.05).IGF Ⅰ( P <0.01),FCP( P <0.01),T( P <0.05) were significantly correlated with BMD in diabetic group.Conclusion Decrease of IGF Ⅰ may play a role in the pathogenesis of osteoporosis in male aged type 2 diabetic patients.