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目的探讨2型糖尿病性骨质疏松与GH/IGF-1平衡的关系。方法纳入54例T2DM患者(其中合并骨质疏松(DO)患者27例,无骨质疏松的患者(DM)27例),正常对照30例,收集受试者一般资料,并采集空腹血检测生长激素(GH)、I型胶原交联C-末端肽(CTX)、I型原胶原N端前肽(PINP)、骨钙素(OT)、胰岛素样生长因子(IGF-1)、钙(Ca)、磷(P)。结果 (1)OP组BMI低于DM组和对照组,3组之间两两比较,差异有统计学意义(P<0.05)。DO组GH较DM组和对照组高(P<0.05),IGF-1水平在DO组有低于DM组趋势,DM组有低于正常对照组趋势,但差异无统计学意义,GH/IGF-1 3组间两两比较差异有统计学意义。DO组PINP、OT、CTX水平有高于DM组和对照组的趋势,但差异无统计学意义。Ca、P 3组差异无统计学意义。(2)CTX(r=-0.335,P<0.05)与PINP(r=-0.373,P<0.05)均与病程呈负相关。IGF-1与PINP(r=0.238,P<0.05)、OT(r=0.636,P<0.05)呈正相关。GH与BMI(r=-0.295,P<0.05)呈负相关。GH/IGF-1与腰椎T值(r=-0.245,P<0.05)、股骨T值(r=-0.232,P<0.05)呈负相关,与BMI呈负相关(r=0.264,P<0.05)。结论GH/IGF-1轴可能参与了2型糖尿病骨质疏松的发生发展。
Objective To investigate the relationship between type 2 diabetic osteoporosis and GH / IGF-1 balance. Methods Totally 54 patients with T2DM (27 with osteoporosis (DO) and 27 without osteoporosis (DM)) were enrolled in this study. Thirty normal controls were recruited. General data of the subjects were collected and fasting blood was collected to detect growth (GH), C-terminal peptide (CTX), PINP, OT, IGF-1, ), Phosphorus (P). Results (1) The BMI in OP group was lower than that in DM group and control group, and there was a significant difference between the three groups (P <0.05). GH in DO group was higher than that in DM group and control group (P <0.05), IGF-1 level in DO group was lower than that in DM group, DM group was lower than that in normal control group, but the difference was not statistically significant -1 3 between the two groups was statistically significant difference. The levels of PINP, OT and CTX in DO group were higher than those in DM group and control group, but the difference was not statistically significant. There was no significant difference between Ca and P 3 groups. (2) There was a negative correlation between CTX (r = -0.335, P <0.05) and PINP (r = -0.373, P <0.05) IGF-1 was positively correlated with PINP (r = 0.238, P <0.05) and OT (r = 0.636, P <0.05). GH was negatively correlated with BMI (r = -0.295, P <0.05). GH / IGF-1 was negatively correlated with T value of lumbar spine (r = -0.245, P <0.05) and T value of femur (r = -0.232, ). Conclusion The GH / IGF-1 axis may be involved in the development of type 2 diabetic osteoporosis.