外源性胰岛素对2型糖尿病的骨密度和骨代谢指标的影响

摘要

Objective To study extraneous source insulin to type 2 diabetes(T2DM)bone mineral density and partial bone metabolism biochemistry indexes influence. Methods Determines the T2DM patient who using QCT 43 example age ≥50 years old normal control group as well as 39 example age ≥50 years old use oral administration falls the sugar medicine control blood sugar (oral administration medicine group) and 36 example use insulin three year above ≥50 the year old T2DM patient(insulin group) the lumbar vertebra bone density,simultaneously records the age,the body weight index,the movement and the sunshine time,the food habit,diabetes course,the menopause age limit (female), after examination HbA1 c, insulin and C peptide ( empty stomach and meal,2h), serum calcium, phosphorus, total alkalinity phosphatase.osteocalcin and urine calcium. Results (1)Compared with the age and the body weight index in control group,the bone density in oral administration medicine group had not remarkable change (P > 0.05). (2)Compared with the oral administration medicine group,the bone density in insulin group increased obviously. (3) The osteocalcin and 2-hour postprandial insulin level in insulin group is higher than that in normal control group and the oral administration medicine group obviously,and there was a significant difference between them(P < 0.01). Conclusion The insulin treatment is beneficial to the osteoporosis patients with type 2 diabetes, which may be related to the higher circulation insulin level in vivo.%目的 研究外源性胰岛素对2型糖尿病(T2DM)患者的骨密度及骨代谢指标的影响.方法 运用QCT测定43例年龄≥50岁健康对照组以及39例年龄≥50岁使用口服降糖药控制血糖的T2DM患者(口服药物组)和36例使用胰岛素3年以上的≥50岁T2DM患者(胰岛素组)的腰椎骨密度,同时记录年龄、体质量指数、运动及日照时间、饮食习惯、糖尿病病程、绝经年限(女性),检测糖化血红蛋白、胰岛素及C肽(空腹及餐后2h)、血钙、磷、总碱性磷酸酶、骨钙素和尿钙.结果 (1)与对照组比较,口服药物组骨密度差异无统计学意义(P＞0.05),(2)与口服药物组比较,胰岛素组骨密度明显增加；(3)胰岛素组骨钙素和餐后2小时胰岛素水平明显高于健康对照组和口服药物组,差异有统计学意义(P＜0.01).结论 外源性胰岛素治疗对2型糖尿病骨质疏松有益,这可能与其体内胰岛素水平较高有关.