老年男性2型糖尿病并存骨质疏松症患者血浆脑钠肽的变化

摘要

Objective To evaluate plasma natriuretic peptide brain (BNP) levels in elderly male patients with type 2 diabetes and primary osteoporosis.Methods A total of 122 elderly male patients with type 2 diabetes were divided into 3 groups according to bone mineral density(BMD):normal group (41 cases),osteopenia group (40 cases) and osteoporosis group (41 cases),and another 33 age matched healthy subjects as control group.Plasma BNP levels were determined by ELISA.Results Plasma BNP levels in osteoporosis group [(1.95 ± 0.49) pmol/L] and osteopenia group [(1.64±0.48) pmol/L] were significantly elevated compared with that in normal group [(1.32±0.38) pmol/L] and control group [(1.26±0.39) pmol/L] (all P＜0.01).There was a statistical difference between osteoporosis group and osteopenia group (t=3.539,P＜0.05),and also between normal group and control group (t=2.726,P＜0.05).Plasma BNP levels had negative correlation with BMD of 2na-4th lumbar vertebra (r=-0.366) and femoral neck (r=-0.375),body mass index (r=-0.288) and estrodiol (E2) (r=-0.352) (all P＜0.05); while had a positive correlation with parathyroid hormone (PTH) (r=0.353,P＜0.05).Conclusions With BMD declining,plasma BNP levels are elevated in elderly male type 2 diabetes,which may be related to the compensatory increase in PTH and the decrease in estradiol.%目的 评价老年男性2型糖尿病合并原发性骨质疏松症患者血浆脑钠肽(BNP)水平.方法 将老年男性患者122例按骨密度分为3组,骨量正常组41例、骨量减少组40例、骨质疏松组41例,另设年龄匹配的体检健康者33例为对照组,以酶标法检测各组血浆BNP水平. 结果 (1)骨质疏松组和骨量减少组血浆BNP明显高于骨量正常组及对照组,分别为(1.95±0.49) pmol/L和(1.64±0.48) pmol/L比(1.32±0.38) pmol/L和(1.26±0.39) pmol/L(P＜0.01),骨质疏松组高于骨量减少组(t=3.539,P＜0.05),骨量正常组高于对照组(t=2.726,P＜0.05)；(2)BNP与L2-4(r=-0.366)及股骨颈的骨密度(r=-0.375)、体质指数(r=-0.288)、雌二醇(r=-0.352)呈负相关(均P＜0.05),与甲状旁腺素呈正相关(r=0.353,P＜0.05). 结论 老年男性2型糖尿病患者随着骨密度的下降,血浆脑钠肽水平升高,可能与甲状旁腺素代偿性升高及雌二醇水平下降有关.