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目的研究病程长短对2型糖尿病患者骨密度及25羟维生素D3的影响。方法选择2型糖尿病患者126例,按其病程分为三组,根据病程分为:A组:病程<5年,40例;B组:病程5~10年,42例;C组:病程>10年,44例;同时选择与糖尿病组年龄、性别比例相当、体重指数相匹配的非糖尿病对照组40例。分别测定所有研究对象血清碱性磷酸酶、血钙、血磷、25羟维生素D3、血糖及胰岛素水平等,应用双能X线法测定腰椎、股骨颈和全身的骨密度。结果 2型糖尿病组较对照组骨密度降低(P<0.05),随着病程延长骨密度呈现下降趋势;A组、B组血钙略高于C组,而A组与B组血钙水平基本相当,差异无统计学意义。随着病程延长,25羟维生素D3呈现下降趋势。结论随着病程的延长,胰岛细胞功能的下降,2型糖尿病患者骨密度呈下降趋势,尤其是病程>10年的2型糖尿病患者25羟维生素D3呈现明显下降趋势,进一步提示2型糖尿病胰岛素细胞功能与25羟维生素D3呈正相关,与骨密度呈正相关,故提示糖尿病患者骨质疏松及骨折风险随病程延长逐渐增加。
Objective To study the effect of duration of disease on bone mineral density and 25-hydroxyvitamin D3 in type 2 diabetic patients. Methods According to the course of disease, 126 patients with type 2 diabetes were divided into three groups according to their course of disease: group A: duration of disease was less than 5 years and 40; group B: duration of 5 to 10 years and 42; group C: duration of disease> 10 years and 44 cases. At the same time, 40 cases of non-diabetic control group with the same age and sex ratio and body mass index matched with the diabetic group were selected. All subjects were measured serum alkaline phosphatase, serum calcium, phosphorus, 25 hydroxyvitamin D3, blood glucose and insulin levels were measured by dual-energy X-ray method of lumbar spine, femoral neck and systemic bone mineral density. Results Compared with the control group, the BMD in type 2 diabetes mellitus patients decreased (P <0.05), and the bone mineral density decreased with the prolongation of disease duration. The serum calcium in group A and group B was slightly higher than that in group C The difference was not statistically significant. With prolonged course, 25 hydroxyvitamin D3 showed a downward trend. Conclusions With the prolongation of the course of disease, the function of islet cells is decreased and the bone mineral density of type 2 diabetic patients shows a declining trend. Especially, the 25-hydroxyvitamin D3 in type 2 diabetic patients with a> 10-year duration shows a declining trend, further suggesting that type 2 diabetic insulin cells Function and 25 hydroxyl vitamin D3 was positively correlated with bone mineral density was positively correlated, it suggests that diabetic patients with osteoporosis and fracture risk increases gradually with the course.