乌鲁木齐地区维族、汉族绝经后糖尿病患者骨代谢结果分析

摘要

Objective To investigate the difference of the bone mineral density and bone metabolic markers between Uygur and Han postmenopausal women with type 2 diabetes, and to provide theoretical basis for the prevention and treatment of osteoporosis. Methods A total of 405 Uygur and Han postmenopausal women with type 2 diabetes, who were hospitalized in the Department of Endocrinology in our hospital from January 2008 to December 2013, were selected.They were divided into two groups according to their nationality.The changes of the serum levels of calcium, phosphorus, alkaline phosphatase, bone gla protein ( BGP) , and 25-hydroxy vitamin D3 were recorded and analyzed.The bone mineral density ( BMD ) was also detected.Results The serum calcium in Uygur patients was slightly lower than that in Han patients, but no significant difference was observed.There was significant difference of the serum phosphorus level between the two groups.The serum levels of alkaline phosphatase, 25-hydroxy vitamin D3 in Uygur patients were significant lower than those in Han patients (P<0.05).The serum BGP level in Uygur group was significant higher than that in Han group ( P<0.05 ) .According to the different duration of menopause, the proportion of patients with low bone mass was higher in Uygur group, and the incidence of osteoporosis in Uygur group was higher than that in Han group.The proportion of Han patients was significantly higher than that of Uygur patients in normal BMD group.BMD of the femoral neck, the greater trochanter, and the lumbar vertebrae in Uygur group was lower than that in Han group.BMD of the femoral neck and the lumbar vertebrae in Uygur patients decreased more significantly than that in Han patients, but there was no significant difference.Conclusion The bone metabolism in Uygur postmenopausal women with type 2 diabetes decreases more significantly than that in Han patients.%目的：探讨新疆维族、汉族绝经后2型糖尿病（T2DM）骨密度变化及骨代谢的差异，为临床骨质疏松症的诊治工作提供进一步依据。方法选取2008年1月－2013年12月于新疆生产建设兵团医院内分泌科住院的维吾尔族、汉族女性且已绝经2型糖尿病患者共405人，按族别分为两组，记录并分析患者血清钙、磷、碱性磷酸酶、骨钙素、25羟维生素D3变化，并进行骨密度测定。结果维吾尔族组血清钙略低于汉族组，但无统计学差异，血清磷水平差异亦不显著；维吾尔族组血清碱性磷酸酶、25羟维生素D3水平均低于汉族组，P＜0．05，维吾尔族组血清骨钙素高于汉族组，P＜0．05；按绝经年限不同统计：维吾尔族女性骨量减低比例较高，发生骨质疏松的比例维吾尔族组亦高于汉族组，骨密度正常组汉族比例明显高于维吾尔族。两组股骨颈、股骨大转子、腰椎骨密度值比较，维吾尔族组骨密度值均低于汉族组，在维吾尔族股骨颈及腰椎骨密度下降更明显，但无统计学差异。结论维吾尔族绝经后糖尿病患者骨代谢水平较汉族下降明显。