2型糖尿病骨密度变化及相关因素初探

目的：观察2型糖尿病骨密度变化及影响因素。方法：对59例男性60例女性2型糖尿病患及148例健康用双能X射线吸收法行L2-4、Wards区、股骨颈、大转子骨密度测量，并测定糖尿病患空腹、餐后血糖，空腹、餐后胰岛素，空腹C肽、24小时尿白蛋白等。结果：①男性糖尿病患L4骨密度较健康显降低，其余部位无显差别。女性糖尿病患L2-4、Wards、股骨颈、大转子均较健康显降低。②多元分析显示：男女性糖尿病患骨密度改变与C肽正相关、与尿白蛋白负相关，男性糖尿病患骨密度改变与病程负相关，女性糖尿病患骨密度改变还与绝经年龄负相关。结论：糖尿病患存在骨密度降低，女性患更为显。2型糖尿病患胰岛功能减退及尿白蛋白增加对骨密度降低有一定作用。

Changes of bone mineraldensity and related factors in type 2 diabetic patients

Objective To investigate the changes of bone mineral density(BMD) in type 2 diabetic patients and the possible factors involved in. Methods Dual energy X ray absorptiometry was used to determine the BMD of lumbar spines(L 2-4 ), femoral neck, Ward's triangle, and trochanter. Fasting blood glucose(FBG), postprandial blood glucose(PBG), fasting insulin(F1NS), postprandial insulin(PINS), fasting C petide(FCP),and urine albumin exeretion rate (UAER) were also measured. Results Compared with normal group, the BMD of L 4 in male diabetic patients significantly decreased, the BMD of L 2-4 , Ward's triangle and trochanter in female diabetic patients significantly decreased. Multivariate regression analysis showed that the changes of BMD were significantly correlated with FCP, UAER for male and female diabetic patients; meanwhile, the changes of BMD were significantly correlated with duration of disease for male diabetic patients and the years after menopause for female diabetic patients. Conclusion BMD significantly decreases in type 2 diabetic patients, to greater extent in female diabetic patients than in male diabetic patients. Islet cell hypofunction and increasied UAER are relatied to decrease of BMD.;