阿仑膦酸钠对绝经后女性2型糖尿病骨质疏松患者骨密度及骨代谢指标的影响

目的探讨阿仑膦酸钠对绝经后女性2型糖尿病(T2DM)合并骨质疏松(OP)患者骨密度(BMD)及骨形成和骨吸收指标的影响。方法将126例T2DM合并OP患者分为两组,治疗组76例,对照组50例。对照组服用钙尔奇D,每日1片,治疗组在服用钙尔奇D的同时,加用阿仑膦酸钠(福善美)70mg,每周1次,连续治疗6个月,比较2组腰椎(L1～4)和股骨颈(NECK)BMD与骨形成(骨碱性磷酸酶)和骨吸收(Ⅰ型胶原N端肽/肌酐)指标。结果治疗组腰椎、股骨颈BMD教对照组明显提高(P<0.05),骨碱性磷酸酶、Ⅰ型胶原N端肽/肌酐明显降低(P<0.01)。对照组BMD治疗前后无明显变化(P>0.05)。结论阿仑膦酸钠能提高T2DM合并OP患者的BMD,并能抑制骨吸收指标,单纯补钙治疗并不能增加骨密度。

The Influence of Bone Mineral Density and Bone Metabolism Indexes in Postmenopausal Women with Type 2 Diabetes and Osteoporosis by Alendronate

Objective To investigate the effects of alendronate to bone mineral density and bone formation and resorption indexes in postmenopausal women with type 2 diabetes mellitus（T2DM） and osteoporosis（OP）.Methods A total of 126 elderly type 2 diabetic women were categorized into treatment group（76）,control group（50）.Caltrate D was given in control group each day,and alendronate（Fosamax） 70mg with caltrate D were given in treatment group each week.Lumbar and hip bone mineral density（BMD）were measured by dual-energy X-ray absorptiometry.The indexes of bone formation（bone alkaline phosphatase） and resorption（Ⅰ type Ⅰ collagen N-terminal peptide/Cr） with BMD were compared after 6 months.Results Lumbar spine,femoral neck BMD was significantly increased to control group（P0.05）,bone alkaline phosphatase and Ⅰ type Ⅰ collagen N-terminal peptide/Cr were significantly decreased（P0.01）.There were no significant changes in BMD in control group after treatment（P0.05）.Conclusions Alendronate improved BMD in patients with T2DM and OP,and could inhibit bone resorption index,pure calcium treatment did not increase BMD.