摘要
目的 探讨男性2型糖尿病（T2DM）患者骨代谢标志物及甲状旁腺素（PTH）、25-羟基维生素D3[25-（OH）D3]、糖化血红蛋白（HbA1c）水平与骨密度的相关性。方法 男性T2DM患者500例,根据其第2~4腰椎、股骨颈和全髋骨的骨密度分为骨量正常组174例、骨量减少组221例和骨质疏松组105例。测定3组患者的身高、体重、空腹血糖、血钙、血磷、血清PTH、25-（OH）D3、特异性碱性磷酸酶（BAP）、N-端中段骨钙素（N-MID-OT）、总Ⅰ型胶原氨基端延长肽（T-P1NP）、Ⅰ型胶原羧基端肽β特殊序列（β-P1CP）及HbA1c水平,分析各指标与骨密度的关系。结果 3组患者年龄、空腹血糖、血钙、血磷、25-（OH）D3水平比较,差异无统计学意义（P〉0.05）;3组患者病程、体重指数、HbA1c、BAP、N-MID-OT、T-P1NP、β-P1CP、PTH的水平比较,差异有统计学意义（P〈0.05）;与骨量正常组比较,骨量减少及骨质疏松组患者体重指数、N-MID-OT和T-P1NP的水平降低,而HbA1c、BAP、β-P1CP、PTH的水平则呈升高趋势（P〈0.05）;校正病程与体重指数后,HbA1c与腰椎2~4、股骨颈、全髋骨部位骨密度均存在明显的负相关关系（P〈0.05）;校正前、校正后PTH水平与腰椎2~4、股骨颈以及全髋骨的骨密度均存在明显的负相关性（P〈0.05）。校正前,25-（OH）D3水平与各部位骨密度无明显的相关性（P〉0.05）,但校正后,其与股骨颈和髋骨骨密度呈正相关关系（P〈0.05）。BAP、N-MID-OT、T-P1NP、β-P1CP水平与各部位骨密度均存在明显的相关性（P〈0.05）;男性T2DM患者的25-（OH）D3与PTH、HbA1c均呈负相关关系（P〈0.05）。500例患者中,维生素D充足者占12.2%（61/500）,不足者占22.2%（111/500）,而缺乏者占比高达65.6%（328/500）。结论 骨代谢标志物、PTH、HbA1c、25-（OH）D3等指标均与男性T2DM患者骨密度变化存在一定相关性,应综合各种因素对男性T2DM患者的骨质�
Objective To investigate the correlation between bone density and the levels of bone metabolism markers,parathyroid hormone（PTH） ,25-dihydroxyvitamin D3 [ 25-（OH） D3 ] and hemoglobin A lc （HbAlc） in male patients with type 2 diabetes mellitus （T2DM）. Methods Five hundred male patients with T2DM were divided into normal bone mass group （n = 174 ）, osteopenia group （n = 221 ） and osteoporosis group（ n = 105） based on the bone density of the 2nd to 4th lumbar vertebrae, femoral neck and total hip. The height, weight, and the levels of fasting blood glucose, serum calcium, serum phosphorus, serum PTH, 25-（OH） D3, bone-specific alkaline phosphatase （BAP）, N-middle osteocalcin（N-MID-OT） ,total procollagen type I amino-terminal peptide（T-P1NP） ,beta-specific sequence of procollagen type carboxy-terminal peptide（13-P1CP） and HbAlc of the patients in the three groups were determined,and the relationship of all indices with bone density was analyzed. Results There was no significant difference in age or levels of fasting blood glucose, serum calcium, serum phosphorus and 25-（OH） D3 among the three groups （P 〉 0.05 ）, but there were significant differences in course of disease, body mass index, levels of HbA1 c, BAP, N-MID-OT ,T-PINP, 13-P1 CP and PTH among the three groups （P 〈 0.05 ）. Compared to the normal bone mass group, the osteopenia group and osteoporosis group had lower body mass index,lower levels of N-MID-OT and T-P1NP, and higher levels of HbA1 c, BAP, β-P1CP and PTH （P 〈 0.05 ）. After course of disease and body mass index had been corrected, HbA1 c had a significant negativecorrelation with bone density of the 2nd to 4th lumbar vertebrae, femoral neck and total hip （P 〈 0.05 ）. Before and after the correction, a significant negative correlation was observed between the PTH level and the bone density of the 2nd to 4th lumbar vertebrae, femoral neck and total hip（P 〈 0.05 ）. Before the correction, the level of 25-（OH） D3 had n
出处
《广西医学》
CAS
2016年第11期1497-1501,共5页
Guangxi Medical Journal
基金
海南省自然科学基金(2011-811152)
关键词
2型糖尿病
骨代谢标志物
甲状旁腺素
骨密度
维生素D
糖化血红蛋白
男性
Type 2 diabetes mellitus, Bone metabolism marker, Parathyroid hormone, Bone density, Vitamin D, Glycosylated hemoglobin, Male
