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目的：比较不同降糖药物对绝经后2型糖尿病患者骨密度及骨代谢指标的影响。方法选取2013年1月至2014年6月晋煤集团总医院收治的绝经后2型糖尿病患者200例，将其随机分为A、B、C、D、E 5组。A 组仅使用二甲双胍治疗，B、C、D、E则在二甲双胍基础上加用胰岛素、格列美脲、吡格列酮、瑞格列奈治疗1年，观察用药前后骨密度及骨代谢指标的变化。结果 A、B、D组治疗前后，腰椎及股骨颈差异有统计学意义（P0.05）。A、B、D组治疗前后，骨碱性磷酸酶（ALP）、骨钙素（BGP）差异有统计学意义（P0.05）；D组治疗前后β-Ⅰ型胶原C端肽（β-CTX-Ⅰ）差异有统计学意义（P<0.05）结论二甲双胍、二甲双胍联合胰岛素对绝经后的2型糖尿病患者的骨密度有正性作用，同时可以增加骨形成标志物骨BGP、ALP的含量。二甲双胍联合吡格列酮对绝经后的2型糖尿病患者的骨密度有负性作用，同时可以减少骨BGP、ALP的含量，增加骨吸收标志物β-CTX-Ⅰ的含量。二甲双胍联合格列美脲或瑞格列奈对骨密度、转化标志物无明显影响。“,”ObjectiveEffects of different hypoglycemic agents on bone mineral density and related parameters in type 2 diabetes mellitus(T2DM)patients with postmenopausal.Methods A total of 200 T2DM patients with postmenopausal were randomly divided into five groups: A,B,C,D,E. A Group only use of metformin treatment, B,C,D and E are on metformin with insulin, glimepiride, pioglitazone, repaglinide treatment for 1 year to observe the changes of bone mineral density and bone metabolic markers before and after treatment.Results Before and after the treatment of A,B,D group, there were statistically significant differences in the lumbar spine and femoral neck (P0.05). A,B,D group before and after treatment, BGP,ALP difference was statistically significant (P0.05);D group before and after treatment, β-CTX-I was statistically significant (P<0.05).Conclusions Metformin, metformin combined with insulin has a positive effect on bone mineral density in postmenopausal women with type 2 diabetes, and can increase the content of BGP and ALP in bone formation markers. Metformin combined with pioglitazone in type 2 diabetic patients with postmenopausal bone mineral density has negative effect, also can reduce bone formation sign bone BGP,ALP content, increased bone resorption markers beta -CTX-I content.Metformin and glimepiride or repaglinide had no effect on bone density, transformation marker.