2型糖尿病患者骨密度变化及其相关因素的探讨

An investigation of the bone mineral density of patients with type 2 diabetes mellitus and the related factors

目的 研究 2型糖尿病 (DM)患者的骨密度变化 ,以了解 2型DM患者是否易合并骨质疏松 (OP)及其相关影响因素。方法 采用双能X线骨密度仪 ,测定 80例 2型DM及 62例性别年龄相匹配的健康者前臂、腰椎、股骨颈、ward区以及大转子的骨密度 ,并对其与年龄、病程、体重指数、绝经年限、空腹血糖、糖基化血红蛋白及部分钙磷调节激素的相关性进行了分析。结果均经统计学处理分析。结果 80例 2型DM患者的骨密度较健康者有不同程度下降 ,按中国人OP推荐诊断标准 ,本组有 36例 (45 % )合并OP ;OP与非OP组的病程、2 4h尿蛋白、绝经年限、FSH、LH水平也存在显著性差异 (P均 <0 0 5)。相关性分析结果发现 :骨密度与患者年龄、病程、绝经年限、FSH、LH呈显著负相关 (P均 <0 0 5)。结论 2型DM患者较易发生OP ,良好的DM及其并发症治疗对预防OP有益。糖代谢紊乱加速了绝经后妇女OP的发生 ,控制血糖并适时给以激素补充治疗对防治OP也是必需的。

Objective\ To investigate the prevalence and pattern of osteoporosis (OP) in the patients with type 2 diabetes mellitus (DM), and the effect of the related factors. Methods\ Bone mineral density (BMD) of nondominant forearm, lumbar vertebrae (L 2-4 ) and hip were measured in 80 patients with type 2 DM and in 62 healthy subjects. The correlation between BMD and age, medical history, menopause duration, BMI, FBG, HbAlc, was analysed student's t test, analysis of variance and coefficient of multiple correlation were used. Results\ BMD decreased in all 80 patients with type 2 DM, of whom 36 (45%) were diagnosed as having OP. BMD signifiantly negatively correlated with age, medical history, menopause duration, FSH and LH ( P <0 05). Conclusion\ There is a high prevalence of OP in the patients with type 2 DM. Control of blood glucose is beneficial to OP patients. The menopausal female should be given hormone replacement therapy. And, anti OP drugs should be used in DM patients.\;