血糖控制对绝经后糖尿病妇女骨密度水平影响的研究

Bone mineral density levels in postmenopausal diabetic women with plasma glucose level regulated to normal

目的 分析血糖水平控制良好的绝经和绝经后Ⅰ型糖尿病、Ⅱ型糖尿病和非糖尿病妇女腰椎和髋部骨密度 (BMD)变化特点及与相关因素的相互关系。方法 对绝经和绝经后排除其他影响骨代谢疾病的 ,并经内科治疗血糖水平控制良好的 1 51例Ⅰ型糖尿病、2 70例Ⅱ型糖尿病和 574非糖尿病妇女 ,用双能X线骨密度仪 (DEXA)测量髋部和腰椎骨密度 ,通过计算机分析用SSPS1 0 0医学统计软件比较 3类人群腰椎和髋部骨密度的差异及其与有关因素的相互关系。结果 血糖水平控制良好的绝经和绝经后Ⅰ型糖尿病、Ⅱ型糖尿病和非糖尿病妇女髋部和腰椎骨密度随年龄增长 ,绝经时间的延长和病程的延长呈同步下降趋势 ,其中以Ward’s区骨密度下降最为明显。同时随着年龄的增加 ,Ⅰ型糖尿病、Ⅱ型糖尿病和非糖尿病妇女骨质疏松及骨量减少的发生率呈明显增加的趋势。而且与年龄和绝经时间呈明显的负相关 ,其相关程度要大于与病程和体重的相关程度。结论 糖尿病妇女良好的血糖控制有利于其骨量的保护 。

Objective To study the changes of bone mineral density (BMD) and the correlation of BMD with confounding factors in menopausal or postmenopausal women with insulin dependent or non insulin dependent diabetes mellitus Methods BMD of lumbar spine (L 2 4 )and proximal femur (femoral neck, Ward's triangle and trochanter major) was measured using dual energy X ray absorptiometry (DEXA) in 151 menopausal or postmenopausal women with insulin dependent diabetes mellitus whose plasma glucose levels were well controlled, and 270 menopausal or postmenopausal women with non insulin dependent diabetes mellitus well controlled, and 574 normal women in menopause or post menopause Statistical analyses of the differences in BMD between the there groups, and of the correlation of BMD with confounding factors, were conducted using SSPS software version 10 0. Results The BMD in the three groups of women decreased with increasing age, duration of menopause, and course of diseases, especially, the decrease of BMD in Ward's triangle was quickest At the same time, the incidence of osteoporosis and bone loss increased prominently with increasing age and duration of menopause A negative correlation was found of BMD levels with age and duration of menopause, and it was higher than that of BMD levels with course of disease and body weight Conclusion The good control of plasma glucose in diabetic women is beneficial to preventing the bone mineral loss, but the postmenopausal reduction of estrogen level is one of the main reasons of the postmenopausal osteoporosis