老年女性2型糖尿病患者骨量变化与骨代谢生化指标的观察分析

摘要

目的 研究老年女性2型糖尿病患者骨量及骨代谢生化指标的变化.方法 运用QCT测定42例正常老年女性以及31例确诊为2型糖尿病的老年女性患者的腰椎松质骨密度,检测糖化血红蛋白(糖尿病组)、胰岛素及C肽(空腹及餐后2h)、性激素、血钙、磷、总碱性磷酸酶、骨钙素及尿脱氧吡啶啉、尿钙、磷.结果 ①老年女性2型糖尿病组骨密度与年龄相匹配的对照组比较无显著差异(P＞0.05)；②老年女性糖尿病组Dpd及BGP水平均高于对照组(P＜0.05),而雌二醇水平低于对照组(P＜0.05).结论 老年女性2型糖尿病患者与正常老年女性相比骨密度无明显差异；血BGP及尿Dpd是老年女性2型糖尿病患者骨代谢紊乱的敏感指标.%Objective To study the changes of bone mineral density and bone metabolic marker in elderly females with type 2 diabetes mellitus. Methods The trabecular bone mineral density of the lumbar spines in 42 elder female controls and 31 elder females with type 2 diabetes mellitus was measured using QCT. Hemoglobin Alc (HbAlc) in type 2 diabetes mellitus patients, insulin (Ins) and C-peptide (CP, fasting and 2h after meals) , sex hormone, serum calcium ( Ca) and phosphorus ( P) , alkaline phosphatase (ALP), bone gla protein ( BGP) , D-Pyridnoline (Dpd), urinary calcium (Uca) and phosphorus (UP) were measured. Results 1) No significant difference of BMD was found between elderly females with type 2 diabetes mellitus and age-matched controls ( P > 0. 05 ) . 2) The levels of Dpd and BGP in elderly females with type 2 diabetes mellitus were higher than those of controls ( P < 0. 05) , but the estrogen level was lower (P <0. 05). Conclusion No significant difference of BMD was found between elderly females with type 2 diabetes mellitus and normal elderly women. Serum BCP and urinary Dpd are sensitive markers of the bone metabolic disorders.