Objective To explore the effect of insulin on the bone metabolism in type 2 diabetic patients and the relative risk factors. Methods 547 type 2 diabetic patients including 188 patients who treated with oral hypnglycemic agents ( Group B ) and 349 patients with insulin ( Group C) were recruited in the study. Another 282 healthy individuals were chosen as normal controls(Group A). BMD levels, HbA1c, FBG, Ca, P and ALP were measured in all groups and body mass index( BMI)were recorded in all the participators. Results ① The level of the bone density in diabetic patients was lower than that in Group A (P ＜ 0.05 ), however, no significant difference was found between Group B and Group C. ②The bone density level of men was higher than that of women in Group C ( P ＜ 0.05 ).③ There were no differences in FBG,Ca,P and ALP between Group B and Grope C,but HbAl.e was significantly decreased in Group C( P ＜0.05 ). ④The change in BMD was respectively negative correlated with the change in duration( r=-O.218,r=-O.Ol8,r=-O.135,P＜O.O5)and age( r=-O.197,r =-0.073,r =-0.129,P＜0.05), while it had a positive correlation with weight( r=O. 230,r=O.352,r=O. 223,P＜O. 05). Conclusion Female, old, long duration and low birth weight were risk factors for osteoporosis with diabetic patients. Insulin therapy have on negative impacts for bone metabolism in patients with type 2 diabetes mellitus.%目的 探讨胰岛素治疗对2型糖尿病患者骨代谢的影响及可能机制.方法 收集547例2型糖尿病患者(口服降糖药188例:B组,应用胰岛素349例:C组)临床资料,测定骨密度(BMD)、空腹血糖、糖化血红蛋白、血钙、血磷、碱性磷酸酶,并对两组患者上述指标进行比较;另设健康对照组(A组)282例,与2型糖尿病患者骨密度进行比较.结果:(1)与健康对照组相比,2型搪尿病患者骨密度降低(P<0.05);(2)C组与B组相比,两组间骨密度无统计学差异,C组男女间比较,男性骨密度高于女性(P<0.05);(3)B组和C组血钙、血磷、血碱性磷酸酶无统计学差异,C组HbA1c明显低于B组(P<0.05);(4)2型糖尿病患者的骨密度与病程、年龄负相关,与体重正相关.结论 女性、高龄、病程长、低体重是糖尿病合并骨质疏松的危险因素,胰岛素治疗对2型糖尿病患者骨代谢无明显影响.
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