绝经后骨质疏松合并2型糖尿病血清25羟维生素D水平研究

摘要

目的 探讨绝经后骨质疏松合并2型糖尿病血清25羟维生素D的水平.方法 选择2010年1月至2011年1月我科住院的51例患者,包括绝经后骨质疏松合并2型糖尿病患者25例,年龄72.38±9.11岁,非糖尿病绝经后骨质疏松妇女26例,年龄68.04±8.28岁.采用美国Norland双光能X线骨密度检测仪对所有患者进行腰椎L2 -L4和左侧股骨近端(包括Neck、Troch、Ward三角区)骨密度测量,并测定身高、体重,病程空腹血糖( FBG)、糖化血红蛋白(HbAlc)、甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白( HDL-C)、低密度脂蛋白(LDL-C),采用酶联免疫吸附法测定两组患者血清25羟维生素D,比较两组25羟维生素D水平.结果 绝经后骨质疏松合并2型糖尿病组患者血清25-羟维生素D 23.31±12.01 ng/ml,较非糖尿病骨质疏松患者36.43±25.91ng/ml低,差异具有统计学意义(P＜0.05)；绝经后骨质疏松合并2型糖尿病组患者空腹血糖7.51±1.83mmol/L、糖化血红蛋白6.70±1.26、甘油三脂1.80±0.74mmol/L较骨质疏松组空腹血糖5.55±1.22mmol/L、糖化血红蛋白5.86±1.05、甘油三脂1.16±0.41 mmol/L增高(P＜0.05)；2型糖尿病合并绝经后骨质疏松患者L2～4、Neck、Ward's三角区、Troch的骨密度分别为0.75±0.11g/cm2、0.64±0.11g/cm2、0.54±0.13g/cm2、0.44±0.12g/cm2与对照组0.76±0.16g/cm2、0.69±0.18g/cm2、0.54±0.11g/cm2、0.47±0.12g/cm2相比较,差异没有统计学意义(P＞0.05).结论 绝经后骨质疏松合并2型糖尿病患者较未合并2型糖尿病骨质疏松维生素D缺乏更严重.%Objective To study the level of 25(OH) VD in postmenopausal women with osteoporosis and type 2 diabetes. Methods SI cases were adopted who were cured in osteoporosis department between Jan. 2010 and Jan. 2011, including 25 postmenopausal females with type 2 diabetes and 26 postmenopausal females without type 2 diabetes. Bone mineral density of L2-L4 ,neck,ward and troch were measured by dual enegy X-ray absorptiometry( DEXA), FBG, HbAlc, TG, TC, HDL-C, LDL-C, BMI were measured, 25 ( OH ) VD was measured with enzyme linked immunosorbent assay and the level of 25 ( OH ) VD were compared. Results The numerical value of 25 (OH) VD was 23.31 ± 12. 01 ng/ml in type 2 diabetes group with osteoporosis and 36. 43 ± 25. 91 ng/ml in control group respectively. The results of 25 ( OH ) VD of two groups have statistical difference(P <0. 05) . The numerical value of FBG,HbAlc,TG were 7. 51 ± 1. 83mmol/L, 6. 70 ± 1. 26,1. 80 ±0. 74mmol/L in type 2 diabetes group and 5. 55 ± 1. 22mmol/L,5. 86 ± 1. 05,1. 16 ± 0. 41mmol/L in control group respectively. The result showed type 2 diabetes group was higher than control group ( P < 0. 05 ). The results of BMD of two groups have no statistical difference. Conclusion Vitamin D deficiency is more serious in postmenopausal osteoporosis women combined with type 2 diabetes group thanpostmenopausal osteoporosis women without type 2 diabetes group.