胰岛素敏感性与糖尿病骨质疏松的相关性研究

目的观察2型糖尿病骨质疏松的发生率，了解胰岛素敏感性与糖尿病骨质疏松的相关性，以早期开展糖尿病骨质疏松的预防和治疗。方法对176例2型糖尿病患者进行骨密度测定，同时测定空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbAlC），计算胰岛素敏感性（ISI），观察胰岛素敏感性与骨质疏松的相关程度。结果176例2型糖尿病患者中有52例（29．5％）出现骨质疏松，75例（42．6％）出现骨密度降低。骨质疏松组与骨密度正常组相比，FPG、HbAlC升高，胰岛素敏感性下降，空腹胰岛素水平降低（P〈0．05〉；骨密度下降组与骨密度正常组相比，胰岛素敏感性下降，空腹胰岛素水平降低（P〈0．05）；但与FPG、HbAlC无明显相关性（P〉0、05）。同时骨质疏松的发生还与糖尿病患者的年龄、糖尿病病程有关。结论2型糖尿病患者易发生骨质疏松；胰岛素不足、胰岛素敏感性降低是骨质疏松的重要相关因素。

Study of the correlation between insulin sensitivity and osteoporosis

Objective To observe the morbidity of osteoporosis in the patients with type II diabetes,and to explore the correlation between insulin sensitivity and osteoporosis,thereby to conduct the prevention and treatment of osteoporosis early.Methods We determined the bone density,free glucose(FPG),free insulin(FINS) and glycosylated hemoglobin(HBA1C) in 176 cases with diabetes.Then we calculated insulin sensitivity(ISI) and studied the correlation degree between insulin sensitivity and osteoporosis.Results Among 176 cases,52 cases(29.5%) had osteoporosis and 75(42.6%) had decreased bone densities.Compared with the patients without osteoporosis,free glucose and glycosylated hemoglobin were elevated in the patients with osteoporosis,but insulin sensitivity and free insulin were decreased(P<0.05).Compared with the cases with normal bone density,insulin sensitivity and free insulin were decreased in the cases with decreased bone density.But the free glucose and glycosylated hemoglobin had no significant difference between the cases with normal and decreased bone density.The development of osteoporosis had a relationship with age,and the disease course of the diabetes patients.Conclusions The patients with type II diabetes are prone to develop osteoporosis.The insufficiency of insulin and the decreased insulin sensitivity are important causes for osteoporosis in the patients with diabetes.