2型糖尿病患者六项性激素与骨密度的相关性研究

探讨2型糖尿病男性患者六项性激素水平与骨密度(BMD)的关系.应用RIA检测49例男性2型糖尿病患者和46例男性非糖尿病患者血清促卵泡生成激素(FSH)、促黄体生成激素(LH)、垂体泌乳素(PRL)、雌二醇(E2)、孕酮(P)和睾酮(T)的水平;用双能X线吸收法测定患者桡骨远端BMD,并按其BMD值分为骨质疏松(OP)组、骨量减少(L)组和骨量正常(N)组.结果显示,2型糖尿病组中BMD明显低于非糖尿病组,有显著差异(P＜0.05);在糖尿病组OP患者FSH、LH、PRL水平升高,E2、T、P水平降低,与非糖尿病组OP者比较有显著性差异(P＜0.05或P＜0.01);与BMD相关因素进行直线回归分析显示:OP患者BMD与FSH、LH、PRL水平呈显著负相关,与T、E2、P水平呈正相关.作者认为男性2型糖尿病患者伴有骨量丢失与垂体-性腺轴功能失衡有关,性腺激素缺乏更容易患骨质疏松.

Relationship Between Serum Sex Hormone and Bone Mineral Density in Patients with Type 2 Diabetes

To explore the relationship between serum sex hormone level and bone mineral density (BMD)in male patients with type 2 diabetes,the serum levels of sex hormone(FSH,LH, PRL,E_2,P and T) were measured by RIA in 49 male patients with type 2 diabetes and 46 male subjects without diabetes.The BMD of all patients in distal radius were measured by dual-ener- gy x-ray absorption method.The patients were divided into 3 groups according to the value of BMD:osteoporosis group (OP),loss bone mass group (L),normal bone mass group (N). The results showed that the BMD in patients with type 2 diabetes were markedly lower than that in patients without diabetes(P<0.05).The serum levels of FSH,LH and PRL in OP group with type 2 diabetes were significantly higher than those in OP group without diabetes(P<0.05).The serum E_2,T and P levels in OP group with type 2 diabetes were markedly lower than those in OP group without diabetes(P<0.01).The serum levels of FSH,LH and PRL were remarkably negatively correlated with BMD.The serum T,E_2 and P were positively cor- related with BMD.The results suggested that the loss of bone mass in patients with type 2 dia- betes is relative to the disturbance of pituitary gonad axis.The patient who lacks gonad hor- mones was susceptible to osteoporosis.