Objective To explore the correlation of bone mineral density (BMD) with levels of N-terminal osteocalcin (N-MID),total collagen type 1 amino-terminal extension peptide,β-collagen special sequence (β-CTX),25-hydroxy vitamin D [25 (OH) D3] and insulin-like growth factor-1 (IGF-1) in postmenopausal women with type 2 diabetes.Methods 116 elderly postmenopausal women with type 2 diabetes were divided into 3 groups according to BMD level:normal group (n=29),osteopenic group (n=49) and osteoporosis group (n=38).Body height,weight,body mass index (BMI) were measured.Fasting blood glucose (FBG),2-hour postprandial glucose (PPG),glycated hemoglobin (HbAlc),24-hour urinary protein (UPro) and levels of N-MID,T-P1NP,β-CTX,25(OH)D3 and IGF-1 were determined.General informations and bone metabolic markers were statistically analyzed and compared between the 3 groups.Results There were no significant differences in levels of FBG,PPG,HbA1c,25(OH)D3 and duration between the 3 groups (all P＞0.05).For the comparison of normal group with osteopenic and osteoporosis groups,BMI and IGF-1 levels were decreased (both P＜0.05) ; T-P1NP and N-MID levels were decreased [(19.85 ± 2.83)μg/Lvs.(12.23±2.75) μg/L,(9.16±2.86) μg/L; (7.12±2.05) μg/Lvs.(5.06±2.38) μg/L,(4.92±2.12) μg/L,all P＜0.05]; 24 h urine protein was increased (P＜0.05); β-CTX level was increased [(1.32±0.38) μg/Lvs.(1.97±0.58) μg/L,(2.14±0.73) μg/L,P＜0.05].Logistic regression analysis showed that BMD was positively correlated with total collagen type 1 aminoterminal extension peptide,IGF-1,25(OH)D3,N MID and BMI (r=0.351,0.217,0.213,0.273,0.203,respectively,P＜0.01 or 0.05),and BMD was negatively correlated with β-CTX and urinary protein levels (r =-0.236 and-0.216,P ＜ 0.05).Conclusions Osteopenia or osteoporosis occurs more often in postmenopausal women with type 2 diabetes.The change of BMD is closely related with bone metabolism markers and IGF 1 level.Routine tests and early prevention can avoid fracture in postmenopausal women with type 2 diabetes.%目的 探讨绝经后2型糖尿病患者的骨密度变化与N-端骨钙素(N-MID)、总1型胶原氨基端延长肽(T-P1NP)、β-胶原特殊序列(β-CTX)、25羟维生素D水平[25(OH)D3]及胰岛素样生长因子-1(IGF-1)的相关性. 方法 选取绝经后女性2型糖尿病患者116例,根据骨密度水平进行分3组,骨量正常组29例、骨量减少组49例和骨质疏松组38例.测量患者身高、体质量,计算体质指数.测定患者空腹血糖(FBG)、餐后2h血糖(PPG)、糖化血红蛋白(HbA1c)及24 h尿蛋白定量(U-PRO),测定3组患者的N-MID、T-P1NP、β-CTX、25(OH)D3及IGF-1的水平,比较3组患者一般临床资料和骨代谢指标并进行统计学分析. 结果 3组患者的FBG、PPG、HbA1c、病程及25(OH)D3差异无统计学意义(P＞0.05);与骨量正常组比较,骨量减少组和骨质疏松组的体质指数、IGF-1的水平降低(P＜0.05),T-P1NP、N-MID水平降低(19.85±2.83) μg/L与(12.23±2.75)μg／L、(9.16±2.86)μg/L(均P＜0.05),(7.12±2.05) μg/L与(5.06±2.38)μg/L、(4.92±2.12) μg/L(均P＜0.05);24 h UPro升高(P＜0.05),β CTX升高(1.32±0.38) μg/L与(1.97±0.58) μg/L、(2.14±0.73)μg/L(均P＜0.05);Logistic回归分析结果显示,骨密度与T-P1NP、IGF-1、25(OH)D3、N MID、体质指数呈正相关(r值分别为0.351、0.217、0.213、0.273、0.203,P值分别为0.001、0.011、0.012、0.001、0.012),与β-CTX、24 h UPro呈负相关(r值分别为-0.236、-0.216,P值分别为0.013、0.015). 结论 绝经后2型糖尿病患者易合并骨量减少或骨质疏松,其骨密度变化与骨代谢标志物及IGF-1水平密切相关,对绝经后2型糖尿病患者应进行常规检测,及早防治,避免骨折的发生.
展开▼
