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目的研究病程长短对2型糖尿病患者骨密度及骨代谢生化指标的影响。方法随机选择2型糖尿病患者68例,按其病程分为三组,Ⅰ组:病程<5年,18例;Ⅱ组:病程5～10年,22例;Ⅲ组:病程>10年,28例,并随机选择与糖尿病组年龄、体重指数相匹配的非糖尿病对照组18例。采用生化法测定所有研究对象血清总碱性磷酸酶、血钙、血磷、尿钙、尿磷等,应用DPX-L型双能X线法测定腰椎、股骨颈和全身的骨密度。结果不同病程长短的3组2型糖尿病患者性别比例相当,糖化血红蛋白水平和合并下肢血管病变差异无统计学意义。2型糖尿病组较对照组骨密度降低(P<0.05);Ⅲ组腰椎、股骨颈及全身的骨密度较对照组减低(P<0.05);Ⅰ组股骨颈及全身的骨密度均高于Ⅲ组(P<0.05)。I组、Ⅱ组血钙明显高于Ⅲ组(P<0.05),而Ⅰ组与Ⅱ组血钙比较差异无统计学意义。结论病程大于10年的2型糖尿病患者骨质疏松发生的危险性增加。
Objective To study the effect of duration of disease on bone mineral density and biochemical markers of bone metabolism in type 2 diabetic patients. Methods A total of 68 patients with type 2 diabetes mellitus were randomly divided into three groups according to their course of disease. Group Ⅰ: duration of disease was less than 5 years and 18; group Ⅱ: duration of 5 to 10 years and 22; group Ⅲ: duration of disease> 10 years; 28 Cases, and random selection and diabetes group age, body mass index matched non-diabetic control group of 18 patients. All subjects were tested for serum total alkaline phosphatase, serum calcium, phosphorus, urinary calcium, urinary phosphorus, etc. using biochemical methods. BMD of the lumbar spine, femoral neck and whole body were measured by DPX-L dual-energy X-ray. Results There were no significant differences in sex ratio between the three groups with type 2 diabetes mellitus with different duration of disease. There was no significant difference in HbA1c and lower extremity vascular lesions. BMD of type 2 diabetes mellitus group was lower than that of control group (P <0.05); BMD of lumbar vertebrae, femoral neck and whole body of group Ⅲ was lower than that of control group (P <0.05); Group B had higher BMD Group (P <0.05). The level of serum calcium in group I and group II was significantly higher than that in group III (P <0.05), while there was no significant difference in serum calcium between group I and group II. Conclusion Patients with type 2 diabetes who have a history of more than 10 years have an increased risk of osteoporosis.