摘要
目的：观察2型糖尿病（T2DM）合并甲状腺功能亢进症（简称甲亢）患者骨代谢指标、骨密度水平,探讨甲状腺功能亢进对2型糖尿病患者骨代谢指标、骨密度的影响。方法：选取2013年2月-2015年4月本院收治的T2DM合并甲亢患者57例作为观察组,另选取同期甲状腺功能正常的2型糖尿病患者79例作为对照组。比较两组患者糖尿病和甲状腺功能相关指标、血清骨特异性碱性磷酸酶（BAP）、N-端中段骨钙素（N-MID-OT）、总1型胶原氨基端延长肽（T-P1NP）、β-胶原特殊序列（β-CTX）、25羟维生素D水平[25（OH）2D3]以及第2-4腰椎（L2-4）、股骨颈、Ward’s三角、大转子区及全身骨密度（BMD）。结果：观察组患者的血清FT3、FT4均明显高于对照组患者,TSH明显低于对照组患者,差异均有统计学意义（P〈0.05）。观察组患者的血清BAP、N-MID-OT、T-P1NP、β-CTX均明显高于对照组患者（P〈0.05）,25（OH）2D3明显低于对照组患者（P〈0.05）;观察组患者体重指数及L2-4、Ward’s三角、股骨颈、大转子区和全身BMD均明显低于对照组患者（P〈0.05）;两组患者骨质疏松发生率比较,差异无统计学意义（P〉0.05）;观察组患者骨量减少发生率明显高于对照组患者（P〈0.05）。结论：2型糖尿病患者合并甲亢可进一步降低骨密度,升高各骨代谢指标,需积极筛查骨密度和骨代谢指标,对防治代谢性骨病具有一定的临床价值。
Objective：To observe the parameters of bone metabolism and bone mineral density（BMD） in patients with Type 2 diabetes mellitus（T2DM） complicated with hyperthyroidism,to discuss the effect of hyperthyroidism for the parameters of bone metabolism and BMD in patients with T2 DM.Method：57 patients with T2 DM complicated with hyperthyroidism from February 2013 to April 2015 in the department of endocrinology of our hospital were selected as the observational group,and 79 patients with T2 DM whose thyroid function was normal on the same period were selected as the control group.The diabetes and thyroid function related indicators,serum levels of bone-specific alkaline phosphatase（BAP）,N-end middle osteocalcin（N-MID-OT）,total type 1 collagen amino terminal peptide（T-P1NP）,β-collagen special sequence（β-CTX）,25（OH）2D3 and BMD of Lumbar 2-4（L2-4）,femoral neck,Ward＇s triangle,trochanter region and whole body between the two groups were compared.Result：The serum levels of FT3,FT4 in the observation group were significantly higher than the control group（P〈0.05）,the serum level of TSH was significantly lower than the control group（P〈0.05）.The serum levels of BAP,N-MID-OT、T-P1NP、β-CTX of the observational group were significantly higher than those of the control group（P〈0.05）,and 25（OH）2D3 was significantly lower than that of the control group（P〈0.05）.The body mass index of observational group and BMD of Lumbar 2-4（L2-4）,femoral neck,Ward＇s triangle,trochanter region and whole body were significantly lower than those of the control group（P〈0.05）.There was no significant difference in the osteoporosis incidence between the two groups（P〉0.05）,and the bone loss incidence of the observational group was significantly higher than that of the control group（P〈0.05）.Conclusion：T2DM complicated with hyperthyroidism can reduced BMD,increase bone metabolism indexes,need screening the BMD and bone metabolism actively,with clinical value for
出处
《中国医学创新》
CAS
2015年第20期62-65,共4页
Medical Innovation of China
关键词
2型糖尿病
甲状腺功能亢进
骨代谢
骨密度
Type 2 diabetes mellitus
Hyperthyroidism
Bone metabolism
Bone mineral density
