2型糖尿病患者骨密度变化及其相关因素的探讨

目的：研究2型糖尿病（DM）患的骨密度变化，以了解2型DM患是否易合并骨质疏松（OP）及其相关影响因素，方法：采用双能X线骨密度仪，测定80例2型DM及62例性别年龄相匹配的健康前臂、腰椎、股骨颈、ward区以及大转子的骨密度，并对其与年龄，病程，体重指数、绝经年限，空腹血糖，糖基化血红蛋白及部分钙磷调节激素的相关性进行了分析。结果：均经统计学处理分析。结果：80例2DM患的骨密度较健康有不同程度下降，按中国人OP推荐诊断标准，本组有36例（45％）合并OP，OP与非OP组的病程，24h尿蛋白，绝经年龄，FSH、LH水平也存在显性差异（P均＜0．05）。相关性分析结果发现：骨密度与患年龄、病程、绝经年限，FSH、LH呈显负相关（P均＜0．05）。结论：2型DM型患较易发生OP，良好的DM及其并发症治疗对预防OP有益，糖代谢紊乱加速了绝经后妇女OP的发生，控制血糖并适时以激素补充治疗对治疗OP也是必需的，建议糖尿病医生在治疗DM的同时应注意OP防治。

An investigation of the bone mineral density of patients with type 2 diabetes mellitus and the related factors

Objective\ To investigate the prevalence and pattern of osteoporosis (OP) in the patients with type 2 diabetes mellitus (DM), and the effect of the related factors. Methods\ Bone mineral density (BMD) of nondominant forearm, lumbar vertebrae (L 2-4 ) and hip were measured in 80 patients with type 2 DM and in 62 healthy subjects. The correlation between BMD and age, medical history, menopause duration, BMI, FBG, HbAlc, was analysed student's t test, analysis of variance and coefficient of multiple correlation were used. Results\ BMD decreased in all 80 patients with type 2 DM, of whom 36 (45%) were diagnosed as having OP. BMD signifiantly negatively correlated with age, medical history, menopause duration, FSH and LH ( P <0 05). Conclusion\ There is a high prevalence of OP in the patients with type 2 DM. Control of blood glucose is beneficial to OP patients. The menopausal female should be given hormone replacement therapy. And, anti OP drugs should be used in DM patients.