绝经期2型糖尿病合并骨质疏松症妇女细胞表型的变化

目的探讨绝经期2型糖尿病合并骨质疏松症妇女细胞表型的变化.方法①采用全自动生化仪测定尿钙/尿肌肝、血钙、血磷、血碱性磷酸酶（AKP）;采用化学发光法测定血甲状旁腺激素（PTH）、骨钙素（BGP）;采用流式细胞仪测定CD3、CD4、CD8、CD25、CD28、CD34、CD40、CD80、CD86、CD95;②骨密度测定采用美国GE PRODIGY公司的双能X线骨密度仪进行测定.结果① 2型糖尿病骨质疏松组与无2型糖尿病的骨质疏松组相比,CD3、CD8、CD28、CD34明显增加（P＜0.05或0.01）;CD4/CD8、CD25、CD80、CD86明显下降（P＜0.05或0.01）.② 2型糖尿病骨质疏松组白细胞分化抗原（CD）与骨密度的相关性分析发现,自然杀伤细胞与第1、2腰椎和股骨干骨密度成正相关（P＜0.01或0.05）;CD3与第1、2腰椎骨密度成负相关（P＜0.05）;CD25与股骨干骨密度成正相关（P＜0.05）;CD34与第4腰椎骨密度成正相关（P＜0.05）;CD95与股骨干、Wards三角骨密度成正相关（P＜0.05）.对无2型糖尿病的骨质疏松组白细胞分化抗原与骨密度的相关性分析发现,CD8/自然杀伤细胞与第1、2腰椎骨密度成正相关（P＜0.05）;CD25与第3腰椎骨密度成正相关（P＜0.05）;人类白细胞抗原基因-DR与第2腰椎骨密度成负相关（P＜0.05）.结论细胞免疫表型的改变与绝经期骨质疏松症的发生可能存在相关性,而在有2型糖尿病的绝经期骨质疏松症患者细胞免疫表型与骨密度关系更为密切.

Changes of cell immune phenotype in the postmenopausal patients with type 2 diabetes mellitus and osteoporosis

Objective To study the changes of cell immune phenotype in the postmenopausal patients with type 2 diabetes mellitus and osteoporosis.Methods CD3,CD4,CD8,CD25,CD28,CD34,CD40,CD80,CD86 and CD95 were measured by flow cytometry technique;Ca/Cr in Urine,Cr,Ca,P,and AKP in serum were measured by automated biochemistry equipment; parathyroid hormone (PTH) and osteocalcin were measured by chemiluminescence.Bone density was measured by dual energy X-ray absorptiometry (DXA) produced by American GE PRODIGY company.Results The production of CD3,CD8,CD28,and CD34 were significantly higher(P<0.05 or 0.01) and the production of CD4/CD8,CD25,CD80 and CD86 were significantly lower in the postmenopausal patients with type 2 diabetes mellitus and osteoporosis than those in the patients with no type 2 diabetes mellitus (P<0.05 or <0.01).The production of natural killing(NK) cell was positively correlated with L1,L2 and femur shaft bone density in the postmenopausal patients with type 2 diabetes mellitus and osteoporosis (P<0.05 or 0.01),but CD3 was negatively correlated with L1 and L2 bone density (P<0.05).CD25 was positively correlated with bone density of femur shaft (P<0.05).CD34 was positively correlated with L4 bone density (P<0.05).CD95 was positively correlated with bone density of femur shaft and Wards triangle bone density (P<0.05).In patients without type 2 diabetes mellitus,CD8/NK cell was positively correlated with L1 and L2 bone density(P<0.05) and CD25 was positively correlated with L3 bone density (P<0.05); human leukocyte antigen-DR was negatively correlated with L2 bone density (P<0.05).Conclusion The changes of cell immune phenotype may be correlated with the incidence of osteoporosis in the postmenopausal patients,while which is closely related with bone density in the postmenopausal patients with type 2 diabetes mellitus and osteoporosis.