新诊断2型糖尿病患者骨密度与骨代谢指标相关性研究
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摘要
目的分析新诊断2型糖尿病患者骨密度及骨代谢指标等相关因素变化。方法选取我院收治的60例新诊断2型糖尿病患者为观察组,同期选取60例正常体检者作为对照组,比较两组一般资料及骨代谢指标,并对骨密度危险因素进行相关性分析。结果观察组HbA1c水平明显高于对照组(P<0.05),观察组骨密度略低于对照组(P>0.05);两组的BALP、OPG及TRAP-5b、CTX水平比较,差异显著(P<0.05)。Pearson相关性分析显示,新诊断2型糖尿病患者骨密度降低与BMI、BALP呈正相关(P<0.05),与年龄、HbA1c、OPG、TRAP-5b、CTX呈负相关(P<0.05)。结论骨代谢指标是新诊断2型糖尿病患者发生骨量异常的早期敏感指标。高龄、低体重、血糖控制不良是新诊断2型糖尿病患者骨质疏松的危险因素,本研究提示早期糖尿病患者已经存在骨重建失衡。
Objective To investigate the correlation of bone mineral density(BMD) and bone metabolic biochemical markers in newly diagnosed type 2 diabetes. Methods Sixty cases of newly diagnosed type 2 diabetes mellitus in our hospital were selected as the observation group, in the same period, 60 normal subjects were selected as the control group.The general data and bone metabolism indicators were compared and the correlation of bone mineral density risk factors were analyzed. Results The level of Hb A1 c in the observation group was significantly higher than that in the control group(P<0.05). The bone mineral density of the observation group was slightly lower than that of the control group(P>0.05).There was significant differences in the levels of BALP, OPG, TRAP-5 b and CTX between the two groups(P <0.05).Pearson correlation analysis showed that bone mineral density decrease was positively correlated with BMI and BALP in newly diagnosed type 2 diabetic patients(P<0.05), and negatively correlated with age, Hb A1 c, OPG, TRAP-5 b and CTX(P <0.05). Conclusion Bone metabolic index is an early sensitive index of bone loss in patients newly diagnosed type 2 diabetes mellitus. Elderly, low weight, poor glycemic control are risk factors for osteoporosis in newly diagnosed type 2 diabetes mellitus. This study suggests that early diabetics have a bone reconstruction imbalance.
Objective To investigate the correlation of bone mineral density(BMD) and bone metabolic biochemical markers in newly diagnosed type 2 diabetes. Methods Sixty cases of newly diagnosed type 2 diabetes mellitus in our hospital were selected as the observation group, in the same period, 60 normal subjects were selected as the control group.The general data and bone metabolism indicators were compared and the correlation of bone mineral density risk factors were analyzed. Results The level of Hb A1 c in the observation group was significantly higher than that in the control group(P<0.05). The bone mineral density of the observation group was slightly lower than that of the control group(P>0.05).There was significant differences in the levels of BALP, OPG, TRAP-5 b and CTX between the two groups(P <0.05).Pearson correlation analysis showed that bone mineral density decrease was positively correlated with BMI and BALP in newly diagnosed type 2 diabetic patients(P<0.05), and negatively correlated with age, Hb A1 c, OPG, TRAP-5 b and CTX(P <0.05). Conclusion Bone metabolic index is an early sensitive index of bone loss in patients newly diagnosed type 2 diabetes mellitus. Elderly, low weight, poor glycemic control are risk factors for osteoporosis in newly diagnosed type 2 diabetes mellitus. This study suggests that early diabetics have a bone reconstruction imbalance.
引文
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[2]邓咏梅,张金山,林炎彬.女性2型糖尿病患者的骨密度变化[J].放射免疫学杂志,2008,21(1):73-75.
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[9]MOLINUEVO MS,SCHURMAN L,MCCARTHY AD,et al.Effect of metformin on bone marrow progenitor cell differentiation:in vivo and in vitro studies[J].J Bone Miner Res,2010,25(2):211-221.
[10]CHEN HH,HORNG MH,YEH SY,et al.Glycemic control with thiazolidinedione is associated with fracture of T2DM patients[J].PLo S One,2015,10(8):e0135530.
[11]PEREIRA M,JEYABALAN J,J RGENSEN CS,et al.Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice[J].Bone,2015(81):459-467.
[12]HINNEN D,NIELSEN LL,WANINGER A,et al.Incretin mimetics and DPP-IV inhibitors:new paradigms for the treatment of type 2 diabetes[J].J Am Board Fam Med,2006,19(6):612-620.
[13]MEIER C,SCHWARTZ AV,EGGER A,et al.Effects of diabetes drugs on the skeleton[J].Bone,2016(82):93-100.
[2]邓咏梅,张金山,林炎彬.女性2型糖尿病患者的骨密度变化[J].放射免疫学杂志,2008,21(1):73-75.
[3]RAKEL A,SHEEHY O,RAHME E,et al.Osteoporosis among patients with type 1 and type 2 diabetes[J].Diabetes Metab,2008,34(3):193-205.
[4]MASCITELLI L,PEZZETTA F.Type 2 diabetes and fracture risk[J].Lancet,2006,368(9537):732.
[5]MIAO J,BRISMAR K,NYR N O,et al.Elevated hip fracture risk in type 1 diabetic patients:a population-based cohort study in Sweden[J].Diabetes Care,2005,28(12):2850-2855.
[6]ENGIN F,LEE B.NOTCHing the bone:insights into multi-functionality[J].Bone,2010,46(2):274-280.
[7]O'BRIEN CA.Control of RANKL gene expression[J].Bone,2010,46(4):911-919.
[8]JABBAR S,DRURY J,FORDHAM JN,et al.Osteoprotegerin,RANKL and bone turnover in postmenopausal osteoporosis[J].J Clin Pathol,2011,64(4):354-357.
[9]MOLINUEVO MS,SCHURMAN L,MCCARTHY AD,et al.Effect of metformin on bone marrow progenitor cell differentiation:in vivo and in vitro studies[J].J Bone Miner Res,2010,25(2):211-221.
[10]CHEN HH,HORNG MH,YEH SY,et al.Glycemic control with thiazolidinedione is associated with fracture of T2DM patients[J].PLo S One,2015,10(8):e0135530.
[11]PEREIRA M,JEYABALAN J,J RGENSEN CS,et al.Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice[J].Bone,2015(81):459-467.
[12]HINNEN D,NIELSEN LL,WANINGER A,et al.Incretin mimetics and DPP-IV inhibitors:new paradigms for the treatment of type 2 diabetes[J].J Am Board Fam Med,2006,19(6):612-620.
[13]MEIER C,SCHWARTZ AV,EGGER A,et al.Effects of diabetes drugs on the skeleton[J].Bone,2016(82):93-100.