老年2型糖尿病患者骨密度、胰岛素样生长因子-1的变化及其相关因素研究

目的 探讨老年2型糖尿病患者骨密度变化及其与胰岛素样生长因子-1(IGF-1)、性激素及各种骨转换因子的相关关系. 方法采用单能定量CT(QCT)对53例2型糖尿病(T2DM)患者及40 例健康老年人进行脊柱骨密度(BMD)测定,并分析受试者的骨密度与体重指数(BMI)、腰臀比(WHR)、IGF-1、性激素、骨钙素(BGP)、骨特异性碱性磷酸酶(B-ALP)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)等指标间的关系. 结果①老年2型糖尿病患者脊柱总BMD低于对照组[(74.75±22.70) mg/cc vs(88.04±28.29) mg/cc,P＜0.05].T2DM组血清IGF-1水平低于对照组[(27.63±5.74) ng/mL vs (32.51±9.68) ng/mL, P＜0.05].②相关性研究显示,T2DM组IGF-1水平与B-ALP呈正相关(r＝0.46, P＜0.01),两组受试者IGF-1水平与所测部位BMD均无相关. 结论老年2型糖尿病患者存在不同程度骨密度下降;IGF-1水平与骨密度的变化无相关性.

Changes of Bone Density and Insulin-like Growth Factor-1 Level in Elders with Type 2 Diabetes Mellitus

OBJECTIVE: To investigate the changes of bone mineral density(BMD) and the relationship of BMD to serum Insulin-like growth factor-1 concentrations, body mass index (BMI), waist hip ratio (WHR), estradiol (E2), testosterone (T), biochemical markers of bone turnover as well as other factors in the elderly individuals with Type 2 diabetes mellitus (T2DM). METHODS: BMDs of spine were measured by quantitative CT for patients with T2DM (n=53) and health controls (n=40). The relationships of BMD related to serum Insulin-like growth factor-1 concentrations, BMI, WHR, E2, T, bone Gla'protein, bone alkaline phosphatase, tartrate resistant acid phosphatase 5b levels were also analyzed. RESULTS: The spine BMD values for the T2DM patients were significantly reduced when compared with controls [(74.75 +/- 22.70) mg/cc vs. (88.04 +/- 28.29) mg/cc, P < 0.05], and the concentration of serum Insulin-like growth factor-1 in T2DM group was significantly lower than that in control [(27.63 +/- 5.74) ng/mL vs. (32.51 +/- 9.68) ng/mL, P < 0.05]. The level of serum Insulin-like growth factor-1 was positive correlation to bone-specific alkaline phosphatase (B-ALP) in the T2DM patients (r = 0.46, P < 0.01). CONCLUSION: The spine BMD in elderly T2DM patients is lower than that in control group. The circulating serum Insulin-like growth factor-1 does not have a significant influence on bone mass in elderly T2DM patients.