老年2型糖尿病患者骨密度及骨超声改变的观察

目的：探讨老年2型糖尿病患者跟骨定量超声（QUS）和腰椎骨密度（BMD）的改变，方法：采用QUS骨量分析系统检测94例老年2型糖尿病患者和90例健康对照者的跟骨超声传导速度（SOS），超声振幅衰减（BUA）及骨强度指数（STI），用双能X线骨吸收测量仪（DXA）测定前后位腰椎BMD，并同时进行了骨生化指标的检测。结果：2型糖尿病患者BMD（g/cm^2)男性L2为0．863，低于对照组的0．931（P＜0．05）；女性L2，L2－4分别为0．826和0．841，均低于对照组0．903和0．905（P＜0．01）；2型糖尿病患者跟骨BUA（dB/MHz)男，女分别为64．63，51．05，均低于对照组71．38和61．76（P＜0．01），糖尿病组STI男，女分别为83．12％和67．64％，低于对照组91．24％和69．03％（P＜0．05）。糖尿病组女性SOS（m/s)为1487．28低于对照组1502．34（P＜0．05）。结论：老年2型糖尿病患者跟骨BUA、SOS和腰椎前后位BMD均较正常对照组降低，提示有骨量丢失。

Clinical study of the changes in bone mineral density and bone ultrasound in elderly patients with type 2 diabetes mellitus

Objective To study the changes and mechanism of calcaneal quantitative ultrasound (QUS)and the bone mineral density( BMD) of AP lumbar spine( L 2-L 4 ) in elderly patients with type 2 diabetes mellitus. Methods Calcaneal broadband ultrasound attenuation ( BUA) ,sound of speed ( SOS ) and stiffness( STI) by QUS ,BMD of the AP lumber spine by dual energy X-ray absorptometry ( DXA ) and some biochemical markers of bone metabolism in elderly patients with type 2 diabetes mellitus ( n=94 )and in healthy control group ( n=90 ) were measured . Results L 2 BMD values(g/cm 2)of male group with type 2 diabetes mellitus was 0.863, which was lower than that of control group ( 0.931, P< 0.05 ). L 2,L 2-4 BMD values ( 0.826 and 0.841 g/cm 2 respectively ) of female group in type 2 diabetes mellitus were lower than that of control groups( 0.903 and 0.905 g/cm 2 respectively, P< 0.01 ); BUA values ( 64.63 dB/MHz for male,51.05 dB/MHz for female) of calcaneal bone in type 2 diabetes mellitus were greatly lower ( P< 0.01 );STI values ( 83.12% for male,67.64% for female ) in type 2 diabetes mellitus were lower than that of control groups ( 91.24%, 79.03% respectively, P< 0.05 ); SOS ( 1487.28 m/s) of female group was lower than that of control group (1502.34 m/s, P< 0.05 ). Conclusions BUA, SOS of calcaneal bone and BMD of the AP lumber spine in elderly patients with type 2 diabetes mellitus are lower than that of control groups,which indicates loss of bone quantity in elderly patients with type 2 diabetes mellitus.