老年男性2型糖尿病肾病患者的骨代谢变化

目的探讨老年男性2型糖尿病及糖尿病肾病患者的骨代谢改变及其影响因素。方法检测糖尿病及糖尿病肾病患者（正常尿蛋白组25例,微量白蛋白尿组25例,临床蛋白尿或肾功能不全者组20例）与正常同龄者（对照组40例）的骨密度和骨代谢指标,并分析其相关性。结果2型糖尿病并发骨质疏松症的比例（65.7%）高于同龄对照组（32.5%）;2型糖尿病患者的糖化血红蛋白（HbA1c）、体重指数（BMI）与骨密度存在相关关系;男性2型糖尿病患者的骨密度和糖尿病病程有关,随着病程的延长,糖尿病患者的骨密度降低明显;临床有蛋白尿或肾功能不全者组的2型糖尿病患者的骨密度降低（P〈0.05或P〈0.01）,微量白蛋白尿期的骨密度也呈下降趋势。结论2型糖尿病患者的骨质疏松症发病率明显增高;血糖控制不良、体重指数偏低是2型糖尿病患者易发骨质疏松的主要危险因素;糖尿病病程及肾脏功能不全是加重男性2型糖尿病患者骨质疏松的重要因素。

BMD and bone metabolism change in elderly males with type 2 diabetes mellitus and diabetic nephropathy

Objective To investigate bone mineral density （BMD） and bone metaholism in elderly males with type 2 diabetes mellitus and diabetic nephropathy, and analyze the incidence and risk factors of osteoporosis Methods Dual Energy X-ray Absorptiometry（ DEXA ）was used to measure BMD of the lumbar spine and proximal femora in 70 males with 2-DM who were over 60 years （including 25 cases of normoalbuminuria, 25 cases of microalbuminuria, 20 eases of clinical albuminuria or renal inadequacy）. Forty normal controls were also examined at tbe same time including data of bone metabolism. Results Decreased BMD in elderly male patients with 2-DM was correlated with prolongation of the clinical course. BMD in the group of renal function insufficiency or elinical albuminuria was much lower than that in the normal control group （P〈0.05 vsP〈0.01）. BMI） in the group of microalbuminuria was also decreased. Conclusions BMD in elderly male patients with 2-DM was associated with the course of diabetes and kidney function. Decreased kidney tunction was an important factor contributing to the occurrence of osteoporosis in elderly male patients with 2-DM.