2型糖尿病患者骨密度与胰岛素水平的相关性研究

目的探讨2型糖尿病患者骨密度的变化及其与空腹血浆胰岛素（FPI）水平的关系。方法应用双光能X线吸收法（DEXA）测定104例2型糖尿病患者（观察组）和46例健康者（对照组）腰椎L1-L4、股骨近端及全身骨密度，用化学发光法测定FPI水平。结果（1）观察组和对照组受检者的FPI水平分别为（1．05±0．40）μU／ml和（0．91±0．25）μU／ml，差异有统计学意义（P〈0．05）；但两组受检者腰椎、股骨颈及全身骨密度分别为（1．12±0．20）g／cm^2与（1．09±0．19）g／cm^2、（0．89±0．16）g／cm^2与（0．90±0．12）g/cm^2、（0．95±0．16）g／cm^2与（0．92±0．30）g/cm^2]比较，差异均无统计学意义（P〉0．05）。（2）观察组和对照组受检者的骨质疏松症患病率分别为14．4％（15／104）和6．5％（3／46），差异无统计学意义（P〉0．05）。（3）将2型糖尿病患者分为2型糖尿病骨量正常组（NBMD组）和2型糖尿病骨量低下组（IBMD组），两组患者的平均年龄、FPI水平及使用胰岛素达1年以上者所占比例（分别为（56．5±12．5）岁与（62．4±9．8）岁、（1．12±0．39）μU／ml与（0．91±0．38）μU／ml、35．8％与8．1％]比较，差异均有统计学意义（P〈0．05）。结论2型糖尿病患者骨密度与健康者相当；高水平的FPI对骨密度有保护作用。

Correlation between Bone Mineral Density and Insulin Level in Type 2 Diabetic Patients

Objective To study the change of bone mineral density (BMD) and its relationship with the level of fasting plasma insulin (EPI) in patients with type 2 diabetes mellitus (T2DM). Methods Dural energy X-ray absorptiometry was used to measure the BMD of the lumbar spines (L_1-L_4), proximal femur and bones of the whole body in 104 T2DM patients and 46 normal controls, and the chemiluminescent immunoassay (CLIA) was used to determine the EPI level. Results ① The FPI levels of the trial group and control group were (1.05±0.40) μU/mL and (0.91±0.25) μU/mL respectively (P<0.05), The levels of BMD of the lumbar spines (L_1-L_4), proximal femur and bones of the whole body were respectively (1.12±0.20) g/cm~2, (0.89±0.16) g/cm~2 and (0.95±0.16) g/cm~2 in the trial group, showed significant differences as compared with (0.92±0.30) g/cm~2,(0.90±0.12) g/cm~2 and (1.09±0.19) g/cm~2 respectively in the control group(P>0.05). ②The prevalence rates of osteoporosis in the two groups were respectively 14.4%(15/104)and 6.5%(3/46) (P>0.05). ③ The diabetic patients were subdivided into NBMD group (T2DM with normal BMD) and IBMD group (T2DM with impaired BMD), then the average age in the NBMD group and IBMD group were (56.5±12.5) and (62.4±9.8) respectively, FPI levels were (1.12±0.39) μU/mL (0.91±0.38) μU/mL respectively, and the ratio of patients whose times of insulin application being more than one year accounted for 35.8% and 8.1% respectively (P<0.05). Conclusion The BMD of type 2 diabetic patients is similar to healthy people, and a higher level of insulin can protect BMD to some extent.