定量CT评估1型糖尿病患者股骨骨密度和骨强度

目的] 采用定量CT评估1型糖尿病患者股骨骨密度和骨强度,并探讨其与胰岛素样生长因子-1(IGF-1)的相关性.方法] 选择本院收治的25例1型糖尿病患者为观察组,选择同期在本院健康体检的25例健康者为对照组.通过三维定量CT计算股骨不同部位体积骨密度(vBMD)和骨强度,检测血清IGF-1、骨特异性碱性磷酸酶(B-ALP)、骨钙素(sOC)、Ⅰ型前胶原氨基端肽(PⅠNP),分析1型糖尿病患者股骨骨密度和骨强度与IGF-1之间的相关性.结果] 与对照组比较,观察组股骨颈皮质vBMD明显降低(582.5±27.7) mg/cm3 vs (558.1± 31.9) mg/cm3,P<0.05] ;股骨粗隆总vBMD、皮质厚度和皮质横截面积显著降低(258.4 ± 42.9) mg/cm3 vs(223.7± 27.3)mg/cm3;(3.3 ± 0.7)mm vs(2.8 ± 0.5)mm;(5.3 ± 1.2)cm2 vs (4.3 ± 0.5)cm2;均P<0.01] .与对照组比较,观察组屈曲比(BR)显著增加(10.8 ±1.8) vs(12.9±1.9), P<0.01] .观察组和对照组血清B-ALP、sOC、PⅠNP水平比较,差异无统计学差异(P>0.05).血清IGF-1与1型糖尿病患者股骨颈总vBMD呈显著正相关性(r=0.48;P<0.05).结论] 定量CT发现1型糖尿病患者股骨粗隆间vBMD、皮质横截面积和皮质厚度较低,血清IGF-1水平可显著影响1型糖尿病患者股骨颈总vBMD.

Evaluation of Bone Mineral Density (BMD) and Bone Strength of Femoral Bone in Patients with Type 1 Diabetes Mellitus under Quantitative CT

Objective]To evaluate the bone mineral density (BMD) and bone strength of femoral bone in patients with type 1 diabetes mellitus by quantitative CT, and the relationship with insulin-like growth factor-1 (IGF-1).Methods]Twenty-five patients with type 1 diabetes mellitus in our hospital were selected as observation group, and 25 healthy subjects in the same period of time in our hospital were selected as control group.Through the three-dimensional quantitative CT, volumetric bone mineral density (vBMD) and bone strength , serum IGF-1, bone alkaline phosphatase (B-ALP), osteocalcin (sOC) and procollagen amino terminal peptide (P I NP) at different parts of femoral bone were calculated ,and the correlation between bone mineral density and bone strength of femoral bone and IGF-1 of type I diabetes mellitus patients were analyzed.Results]Compared with the control group, the femoral neck cortex vBMD of the observation group was significantly reduced (582.5 ± 27.7) mg/cm3 vs (558.1± 31.9) mg/cm3,P<0.05];The total vBMD, cortical thickness and cortical cross-sectional area were significantly lower (258.4 ± 42.9) mg/cm3 vs(223.7± 27.3)mg/cm3;(3.3 ± 0.7)mm vs(2.8 ± 0.5)mm;(5.3 ± 1.2)cm2 vs (4.3 ± 0.5)cm2;mean P<0.01].Compared with the control group, the BR of the observation group was significantly increased(10.8 ±1.8) vs(12.9±1.9),P<0.01];The serum levels of B-ALP, sOC, P I and NP in the observation group and the control group had no significant difference (P>0.05).There was a significant positive correlation between serum IGF-1 and total vBMD of femoral neck in patients with type 1 diabetes mellitus (r=0.48;P<0.05).Conclusion]Quantitative CT revealed that vBMD, cortical cross-sectional area and cortical thickness were lower in patients with type 1 diabetes.Serum IGF-1 level can significantly affect the total vBMD of femoral neck in patients with type 1 diabetes mellitus.