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目的 研究非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的骨密度变化，以了解ＮＩＤＤＭ 患者是否易合并骨质疏松及其特点。方法 采用双能Ｘ线骨密度仪（ 简称为ＤＸＡ），测定４８ 例ＮＩＤＤＭ 患者及３５ 例３０ ～３５ 岁正常人腰椎正侧位、髋部及全身骨密度。病例选择是根据１９８５ 年世界卫生组织（ＷＨＯ） 糖尿病专家委员会提出的诊断和分型标准，结果均经统计学处理分析。结果 ４８ 例ＮＩＤＤＭ患者的骨密度都有不同程度下降，按ＷＨＯ推荐诊断骨质疏松标准，本组有２５ 例（５２－１ ％） 合并骨质疏松；ＮＩＤＤＭ 合并骨质疏松患者男女髋部骨密度均值与同性别骨密度峰值比较，骨密度下降率分别为１４－１％ 和１５－６％ ，高于腰椎骨密度下降值。结论 ＮＩＤＤＭ 患者较易发生骨质疏松，其骨密度下降以髋部丢失最早，全身骨量丢失明显；糖尿病病程及绝经后时间愈长，骨密度下降越明显，呈负相关；ＮＩＤＤＭ合并骨质疏松的发生机理，除钙的排出增多和继发性甲状旁腺功能亢进所引起骨吸收亢进外，还与血清骨碱性磷酸酶、类胰岛素生长因子明显下降等因素有关，导致骨形成明显减低。
Objective To investigate the changes of bone mineral density (BMD) in non-insulin dependent diabetes mellitus (NIDDM) patients and to find out whether NIDDM patients are susceptible to osteoporosis. Methods Bilateral energy X-ray absorptiometry (DXA) was used to measure the posterior aspect, hip and whole body BMD of 48 patients with NIDDM and 35 healthy people aged 30-35 years. Case selection is based on the 1985 World Health Organization (WHO) Committee of Experts on Diabetes diagnosis and classification criteria, the results were statistically analyzed. Results The bone mineral density of 48 patients with NIDDM decreased to varying degrees. According to WHO criteria for diagnosing osteoporosis, 25 patients (52-1%) had osteoporosis in this group. The bone mineral density (BMD) of male and female patients with NIDDM complicated with osteoporosis Compared with the mean peak BMD, the mean BMD decreased 14-1% and 15-6% respectively, which was higher than the decrease of lumbar BMD. Conclusions Osteoporosis is more likely to occur in patients with NIDDM, with the earliest loss of hip and the loss of whole body bone loss. The duration of diabetes mellitus and postmenopausal period is longer, the more significant and negative correlation exists between the decline of bone mineral density and NIDDM with osteoporosis The mechanism of occurrence, in addition to increased calcium excretion and secondary hyperparathyroidism caused by excessive bone resorption, but also with serum bone alkaline phosphatase, insulin-like growth factor decreased significantly and other factors, resulting in significantly reduced bone formation.