老年2型糖尿病患者骨密度与血清胰岛素水平和BMI关系的临床观察

目的研究老年2型糖尿病(DM)患者骨密度的改变及探讨其与胰岛素水平的关系。方法应用DEXA测定38例老年2型DM患者和26例老年健康对照组L2-4及股骨近端骨密度(BMD)并测定2型DM患者血清胰岛素(Ins)及体重指数(BM I)。结果①2型糖尿病中男、女W ard`s区、男性腰椎、女性股骨颈BMD均显著低于正常对照组(P<0.05);男性股骨颈、女性腰椎的BMD低于正常对照组,但无统计学意义(P>0.05)。②将DM患者分成骨质疏松组(OP组)和非骨质疏松组(非OP组),比较两组的血Ins水平和BM I,发现非OP组空腹及餐后2 h Ins水平和BM I明显高于OP组(P<0.05)。结论①老年2型DM患者较易发生OP。②肥胖和血中高胰岛素水平对骨密度有一定保护作用。

Relationship between the bone mineral density with insulin level in elderly patients with type 2 diabetes mellitus

Objective To study the relationship between the bone mineral density(BMD) and the insulin level in elderly patients with type 2 diabetes mellitus.Methods Dural energy X-ray absorptimetry was used to measure the BMD of lumbar spines(L2-4) and proximal femur in 38 elderly patients with type 2 diabetes mellitus and 26 cases of normal control,serum insulin level and BMI of the patients also were determined.Results ① The BMD of Ward's triangle in male and female patients and neck of femur in male patients and lumbar spines in female patients was significantly lower than that of the control group(P<0.05).② The diabetic patients were divided into osteoporosis and non-osteoporosis,The levels of fasting,postprandial 2 hour insulin and BMI in the group of non-osteoporosis were significantly higher than those of the group of osteoporosis.Conclusions ① The type 2 diabetes mellitus could cause osteoporosis in aged patients.② Fatness and hyperinsulinism can protect bone density to some extent.