糖尿病微血管病患者骨密度及骨钙素测定的意义

目的：探讨糖尿病微血管病变对骨密度及骨钙素水平的影响。方法：选择2型糖尿病患者60例，按其是否合并糖尿病微血管病(眼病、肾病、神经病变)分为两组，合并微血管病(1组)33例，不合并微血管病(2组)27例。用生化法测定两组的空腹血糖(FBG）、果糖胺(GSP)、血清总碱性磷酸酶(TALP)及血钙(Ca^2 )，RIA测定骨钙素(BGP)，DEXA法测定腰椎和髋部骨密度(BMC)；按其身高、体重计算体重指数(BMI)。结果：两组BBMI、GSP、TALP及Ca^2 均未见明显差异；1组血清BGP水平明显低于2组，有显著性差异；1组第2—4腰椎（L2-4)、股骨颈、Ward’s三角区及股骨大转子的BMD均低于2组，差异有显著性。结论：骨密度及骨钙素与糖尿病微血管病变关系密切。认为糖尿病微血管病可能降低骨形成，加重骨质疏松。

Significance of Determination of Bone Mineral Density and Osteocalcin in Diabeitc Patients with Diabetic Microvascular Complications

Objective To study the influence of diabetic microvascular complications on bone mineral density (BMI) and osteocalcin(BGP). Methods 60 patients with type 2 diabetes mellitus were studied, including 33 with microvascular complications (retinopathy, nephropathy, neuropathy)(group 1) and 27 without complications (group 2). Fasting blood glucose, serum fructosamine (GSP), total alkaline phosphatase (TALP), calcium (Ca 2+ ) levels were measured by biochemical method; osteocalcin(BGP) level was detected by RIA. BMD of the lumbar spine and femur was measured by dual energy X-ray absorptiometry in all patients. Body mass index (BMI) was calculated from the height and body weight. Results The BMI, GSP, FBG, TALP and Ca 2+ values in the two groups were not much different, but BGP and BMD in group 1 were significantly lower than those in group 2. Conclusion Bone mineral density (BMD) and BGP values were closely related to the microvascular complications in diabates, Which could decrease bone formation and increase the frequency of osteoporosis.