2型糖尿病患者血糖水平与骨代谢的相关研究

Correlational research between blood glucose level and bone metabolism in patients with type 2 diabetes mellitus

目的:观察2型糖尿病(T2DM)患者血糖水平与骨代谢的关系。方法:选择T2DM患者112例,根据糖化血红蛋白(HbA1c)分为A组:HbA1c<7.0%;B组:HbA1c≥大于7.0%,选健康正常人作为C组,对3组资料进行比较。结果:①A、B组的β-胶原特殊序列(β-CTX)、空腹血糖(FPG)及餐后血糖(2 hPG)高于C组(P<0.05),B组高于A组(P<0.05);A、B组的总25(OH)维生素D、骨钙素(N-MID)、总Ⅰ型胶原氨基延长肽(T-P1NP)低于C组(P<0.05),B组低于A组(P<0.05)。C组的骨密度T值(T-score)及骨密度(BMD)高于A、B组(P<0.05),A、B组比较差异无统计学意义(P> 0.05)。②相关性分析:HbA1c与T-score、BMD、T-VitD、N-MID、T-P1NP呈负相关,与β-CTX呈正相关。结论:T2DM影响骨代谢,随HbA1c的升高,骨吸收增加,骨形成减少。

Objective:To observe the relationship between blood glucose level and bone metabolism in patients with type 2 diabetes mellitus(T2DM).Methods:112 patients with T2DM were divided into Group A(HbA1c<7.0%)and Group B(HbA1c≥7.0%)according to HbA1c,and normal subjects were selected as Group C.Data of three groups were compared.Results:1.The specific sequence ofβ-collagen(β-CTX),fasting blood glucose(FPG)and postprandial blood glucose(2 hPG)in Group A and B were higher than those in Group C(P<0.05),and those in Group B were higher than those in Group A(P<0.05);the total 25(OH)vitamin D,osteocalcin(N-MID)and total collagen I amino prolongation peptide(T-P1NP)in Group A and B were lower than those in Group C(P<0.05),while those in Group B were lower than those in Group A(P<0.05);T-score and BMD of Group C were higher than those of Group A and B(P<0.05),but there was no difference between Group A and B(P>0.05).Correlation analysis showed that HbA1c was negatively correlated with T-score,BMD,T-VitD,N-MID and T-P1NP,and positively correlated withβ-CTX.Conclusion:T2DM affects bone metabolism.With the increase of HbA1c,bone resorption increases and bone formation decreases.