论文部分内容阅读
目的研究糖尿病早期骨代谢改变。方法测定６周实验性糖尿病（ＳＴＺ－ＤＭ）大鼠空腹血糖、ＨｂＡ１ｃ、胰岛素、钙离子浓度、骨钙素、降钙素、ＰＴＨ和维生素Ｄ３。收集２４ｈ尿，测定白蛋白、肌酐、吡啶酚。结果糖尿病大鼠与正常对照组相比，血清钙浓度显著升高［（１３５．８５±１１．２８）对（１１７．２１±６．５２）ｍｇ／Ｌ，Ｐ＜０．０１］，骨钙素水平升高［（０．０７±０．０４）对（０．０５±０．０１）ｎｇ／ｍｌ，Ｐ＜０．０５］，维生素Ｄ３水平显著降低［（７．６３±１．８８）对（１１．５５±４．１１）ｎｇ／ｍｌ，Ｐ＜０．０５］，尿吡啶酚／肌酐显著降低［（４．７９±０．７５）对（７５．８４±６０．６７）ｎｍｏｌ／ｍｍｏｌ，Ｐ＜０．０１］；而血清降钙素和甲状旁腺素水平改变无统计学意义。结论糖尿病状态下存在骨代谢异常，主要表现为维生素Ｄ３降低、骨钙素升高及尿吡啶酚水平降低。糖尿病性骨质疏松可能与维生素Ｄ３水平降低及由于胰岛素缺乏所致的骨胶原合成障碍有关
Objective To study the early changes of bone metabolism in diabetes. Methods Fasting plasma glucose, HbA1c, insulin, calcium concentration, osteocalcin, calcitonin, PTH and vitamin D3 in 6-week experimental diabetic rats were measured. 24h urine collection, determination of albumin, creatinine, pyridinol. Results Compared with the normal control group, the serum calcium level in diabetic rats increased significantly ([(135.85 ± 11.28) vs (117.21 ± 6.52) mg / L, P <0.01] The level of vitamin D3 was significantly lower than that of the control group [(0.07 ± 0.04 vs 0.05 ± 0.01) ng / ml, P <0.05] For (11.55 ± 4.11) ng / ml, P <0.05], urinary pyridinol / creatinine significantly decreased (4.79 ± 0.75 vs. 75.84 ± 60.67 nmol / mmol, P <0.01], while serum calcitonin and parathyroid hormone levels did not change significantly. Conclusion There is abnormal bone metabolism in diabetic state, which is mainly caused by the decrease of vitamin D3, the increase of osteocalcin and the decrease of urinary pyridinol. Diabetic osteoporosis may be associated with decreased levels of vitamin D3 and disorders of collagen synthesis due to insulin deficiency