2型糖尿病患者骨密度变化及血清IGF-1水平

目的 观察2型糖尿病患者不同性别、不同年龄阶段以及肥胖与非肥胖状态下IGF-1血清浓度及前臂骨密度水平。方法2型糖尿病100人,根据年龄、体重分别进行分组。ELISA法测定血清IGF-1浓度,双能X线骨密度检测仪(DEXA)测量前臂超远端(尺桡骨远端1/10交界处)及中远端(尺桡骨远端1/3交界处)骨密度(BMD)、骨矿含量(BMC)及T积分。结果 骨质疏松症的患病率为14％(<50岁组)到73％(>70岁组),总患病率为33％(超远端)和27％(中远端)。其中女性患病率为47.7％和22.7％,男性为21.4％和30.4％。BMD、BMC、IGF-1血清水平随增龄逐渐低降,50岁以后女性BMD、BMC较男性显著下降。肥胖者的:BMD、BMC较非肥胖者高,非肥胖女性骨质疏松症的患病率升高。IGF-1在男性与女性之间及肥胖与非肥胖者之间均无差异。结论 2型糖尿病非肥胖者的骨密度低于肥胖者,女性低于男性,非肥胖女性易在前臂超远端发生骨质疏松症。:IGF-1不受性别和体重的影响,随增龄逐渐减少。

The variation of bone mineral density and serum IGF-1 levels in type 2 diabetes mellitus

Objective To observe the serum IGF-1 levels and the bone mineral density of forearm as well as their relationship with age, sex and BMI in type 2 diabetes mellitus. Methods In 100 objects, which divided into different groups according to age and body weight, fasting serum concentrations of IGF-1 were detected by ELISA, and BMD, BMC and T score of ultra-distal (the 1/10 juncture of ulna and radius) and distal (the 1/3 juncture of ulna and radius) of forearm were measured by dual energy X-ray absorptiometry(DEXA) . Results The total prevalence of osteoporsis was 33% (ultra-distal) and 27% (distal) in 100 type 2 diabetes objects, which was form 14 % ( < 50 years group) to 73 % (> 70 years group) . The prevalence of osteoporsis in female were 47.7% (ultra-distal) and 22.7% (distal), while in male were 21.4% and 30.4% . BMD, BMC and serum IGF-1 concentrations gradually reduced with ageing. BMD and BMC reduced obviously after 50 years old in female than in male, in fat group than in non-fat group. While the prevalence of ultra-distal osteoporsis was higher in non-fat women. There was no difference in serum IGF-1 concentrations between male and female, fat group and non-fat group. Conclusion In type 2 diabetes mellitus, BMD and BMC reduced obviously in female than in male, in non-fat group than in fat group. The prevalence of ultra-distal osteoporsis is higher in non-fat women. IGF-1 has no corelation with sax and weight but gradually decreases with ageing. .