老年糖尿病并骨质疏松血IGF-1、骨钙素与胰岛素抵抗的相关性研究

目的：探讨老年糖尿病并骨质疏松血清胰岛素样生长因子-1（IGF-1）、骨钙素（BGP）的水平变化与胰岛素抵抗及骨密度（BMD）的关系。方法：选取2012年10月-2013年5月在本院老年病科住院治疗的108例糖尿病患者，年龄≥60岁，根据骨密度测定结果及骨质疏松症诊断标准分为观察组62例和对照组46例，比较两组间的空腹血糖（FBG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、IGF-1、BGP及BMD水平，分析血清IGF-1、BGP水平与各项指标的相关性。结果：观察组的FBG、FINS、HOMR-IR、LDL-C水平均明显高于对照组，而HDL-C、BGP及BMD水平均明显低于对照组（P〈0.01或P〈0.05）；两组患者血清游离IGF-1、BGP水平与年龄、FBG、FINS、HOMA-IR、LDL-C水平呈负相关， IGF-1与BGP及BMD水平呈正相关（P〈0.01或P〈0.05）。结论：低血清IGF-I水平、低血清BGP水平及胰岛素抵抗是糖尿病并骨质疏松症发生发展的危险因素。

Correlation Study between Insulin-like Growth Factor-1,BGP and Insulin Resistance in Senile Diabetes ;Combine Osteoporosis

Objective：To investigate the correlation between insulin-like growth factor-1,BGP and insulin resistance with senile diabetes combine osteoporosis.Method：One hundred and eight patients with senile diabetes in our hospital from October 2012 to May 2013 were selected,age≥60 years old,they were divided into the experimental group for 62 cases and the control group for 46 cases according to body mass index,the diagnosis standard of osteoporosis.The levels of fasting blood glucose（FBG）,fasting serum insulin（FINS）,insulin resistance index（HOMA-IR）,LDL-cholesterol （LDL-C）,HDL-cholesterol（HDL-C）,insulin-like growth factor-1 IGF-1,boneγ-caboxyglutamic acid-containing protein（BGP）and bone mineral density（BMD）between the two groups were compared.The correlations between serum IGF-1,BGP and the above indicators were analyzed.Result：The levels of serum FBG,FINS,HOMA-IR and LDL-C in the experimental group were significantly higher than the control group,HDL-C,BGP and BMD were significantly lower than the control group（P〈0.01 or P〈0.05）.The levels of serum IGF-I,BGP were negatively correlated with age, FBG,FINS,HOMA-IR and LDL-C,the levels of serum IGF-I was positively correlated with BGP and BMD（P〈0.01 or P〈0.05）.Conclusion：The low level of IGF-1,BGP and insulin resistance were also risk factors of senile diabetes combine osteoporosis and maybe participated in the development of it.