2型糖尿病女性患者骨密度与骨转换率的相关性

目的探讨2型糖尿病(T2DM)女性患者骨密度与骨转换及骨重建的相关性。方法回顾性分析纳入在南方医科大学第三附属医院内分泌科住院的201例T2DM女性患者住院期间的临床数据，采用双能X线骨密度仪，测量骨密度，包括腰椎、左侧股骨颈和髋部总体，将纳入对象分为骨量正常组85例(T>-1)、骨量减少组87例(-2.5 < T < -1)和骨质疏松组29例(T < -2.5)，检测骨钙素N端中分子片段和β-Ⅰ型胶原C-末端交联分别评估骨形成和骨吸收。根据骨形成和骨吸收的T值分别计算骨转换率和骨重建率，比较T2DM患者骨质疏松组和骨量正常组患者的的骨转换率T值以及骨重建率T值的差异，并评估T2DM女性患者骨转换率T值和骨重建率T值与骨密度之间的相关性。结果T2DM女性患者骨质疏松组的骨转换率T值与T2DM女性患者骨量正常组的骨转换率T值差异有统计学意义(P=0.041)，T2DM女性患者骨转换率T值与髋部骨密度负相关(r=-0.14，P =0.049)。校正糖化血红蛋白后，T2DM女性患者骨转换T值与髋部仍呈骨密度负相关(r=-0.144，P=0.043)。结论在T2DM女性患者中，随着骨转换率的增高，患者骨密度越低，并发低创伤性骨折的风险也会随之增高。 

Correlation between bone mineral density and bone turnover rate in type 2 diabetes mellitus women

ObjectiveTo investigate the correlation between bone mineral density (BMD) and bone turnover rate in type 2 diabetes mellitus (T2DM) women.MethodsWe collected the clinical data of 201 women with T2DM in the Third Affiliated Hospital of South Medical University. Bone mineral density (BMD) at lumbar spine, the left femoral neck and the total hip were measured with dual energy X-ray absorptiometry. The selected subjects were divided into normal bone mass group (n=85, T>-1)、osteopenia group (n=87, -2.5 < T < -1) and osteoporosis group (n=29, T < -2.5). The T-score of bone formation and the T-score of bone resorption were calculated by testing osteocalcin and β-C-terminal telopeptide of typeⅠcollagen (β-CTX) respectively. The bone turnover rate and the bone remodeling rate in T2DM patients were evaluated by comparing the T-score of the bone turnover and bone remodeling between osteoporosis group and normal bone mass group, to investigate the correlation between the T-score of the bone turnover and bone remodeling and BMD in T2DM patients.ResultsThe T-score of the bone turnover rate showed significant differences between the osteoporosis group and the normal group in T2DM patients (P= 0.041). The T-score of the bone turnover rate was negatively correlated with hip BMD in T2DM patients (r=- 0.14, P=0.049). Controlling the glycosylated hemoglobin factors, the T-score of the bone turnover rate was negatively correlated with hip BMD in T2DM patients (r=-0.144, P=0.043).ConclusionWith the bone turnover rate increasing, BMD decreased and the risk of T2DM patients with hip osteoporosis would be increased.