老年男性2型糖尿病及糖尿病肾病患者的骨密度及骨代谢变化

目的: 探讨老年男性2型糖尿病和糖尿病肾病患者的骨密度及骨代谢以及影响因素。方法: 用DEXA测定了131 例60岁以上的男性2型糖尿病患者(正常蛋白尿组73例,微量白蛋白尿组30例,临床蛋白尿或肾功能不全者组28 例)和49 例对照组的腰椎与股骨近端骨密度,并检测生化及骨代谢指标。结果: 男性2 型糖尿病患者的骨密度和糖尿病病程有关,随着病程的延长,糖尿病患者的骨密度降低加重。临床蛋白尿或肾功能不全者组的2 型糖尿病患者的骨密度显著降低(P<0.05或P<0.01),微量白蛋白尿期的骨密度也呈下降趋势。结论: 男性2 型糖尿病患者的骨量丢失程度与糖尿病病程及肾脏功能有关,肾脏功能下降是加重男性2型糖尿病患者骨质疏松的重要因素。

Change of Bone Mineral Density and Bone Metabolism in Elderly Male Type 2 Diabetes Mellitus and Diabetic Nephropathy

Objective: To investigate the bone mineral density (BMD) and bone metabolism in elderly male type 2 diabetes mellitus and diabetic nephropathy. Methods: Dual energy X-ray absorptiometry was used to measure the BMD of lumbar spines and proximal femoral in 131 male 2-DM which were over 60 years old (including 73 cases of normoalbuminuria, 30 cases of microalbuminuria, 28 cases of clinical albuminuria or renal inadequacy) and 49 normal controls. At the same time,was also examined bone metabolism. Results: The decrease of BMD in elderly male patients with 2-DM was related to the prolongation of clinical course. The BMD in group of renal function insufficiency or clinical albuminuria were much lower than that in group of normal control (P< 0.05 vs P<0.01).The BMD in group of microalbuminuria was also decreased. Conclusion:The BMD in elderly male patients with 2-DM was associated with the course of diabetes and kidney function. The decline of kidney function was an important factor in development of osteoporosis in elderly male patients with 2-DM.