2型糖尿病患者血清25(OH)D浓度及骨代谢指标水平的分析

Analysis of serum 25(OH)D levels and bone turnover markers in type 2 diabetes

目的观察2型糖尿病(T2DM)患者血清25-羟基维生素D[25(OH)D]、甲状旁腺素(PTH)及全端骨钙素(OC)、I型胶原氨基末端前肽(P1NP)、I型胶原氨基末端前肽(β-CTX)的变化,分析T2DM患者和非糖尿病者骨代谢指标的差异。方法选取T2DM患者166例作为糖尿病组,并按骨密度测定的T值分为骨质疏松组、骨量减少组、骨量正常组;另选健康人群62例作为正常对照组。测定两组血清25(OH)D、PTH指标及OC、P1NP和β-CTX浓度。结果糖尿病组中骨质疏松及骨量减少例数明显高于正常对照组、血25(OH)D和OC水平低于对照组;糖尿病组与正常对照组的PTH、P1NP和β-CTX水平无显著差异,但在糖尿病骨量减少组和骨质疏松组中P1NP和β-CTX水平明显增高。结论 T2DM患者存在维生素D缺乏现象,其发生骨质疏松以及骨量减少的概率明显增加。可对T2DM患者定期进行骨代谢相关检查,以便早期发现并诊断糖尿病性骨质疏松。

Objective To observe the levels changes of serum 25(OH)D,PTH,OC,P1 NP andβ-CTX in T2 DM,and to analyze the difference of bone metabolism indexes between type 2 diabetic and non-diabetic patients.Methods 166 cases with T2 DM were selected and divided into osteoporosis group,osteopenia decreased group and normal bone mass group according to T value of bone mineral density,62 healthy cases as contrast group.Serum 25(OH)D,PTH,OC,P1 NP andβ-CTX concentrations were measured.Results The cases number of osteoporosis and osteopenia decreased in diabetes were more than contrast group,and the blood 25(OH)D,OC concentrations were lower.The level of PTH,P1 NP andβ-CTX were no difference between diabetes group and contrast group,but it was significantly higher in the osteopenia decreased group and the osteoporosis group.Conclusion Vitamin D deficiency is present in patients with T2 DM,and the probability of osteoporosis and bone loss are significantly increased.Diabetic osteoporosis can be detected and diagnosed early by regular monitoring of bone metabolism in patients with T2 DM.