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目的探讨老年2型糖尿病(T2DM)合并视网膜病变患者骨密度(BMD)变化的特点。方法测定56例老年T2DM合并糖尿病视网膜病变患者(DR组)、60例无糖尿病视网膜病变T2DM患者(NDR组)和58例健康老年人(健康对照组)股骨颈、大转子、Ward’s三角区(ward’s)及前后位腰椎BMD,并检测血清骨钙素(BGP)、血钙(Ca)、血磷(P)、甲状旁腺激素(PTH)及Ⅰ型胶原降解产物(Crosslaps)/尿肌酐(Cr)水平。结果DR组的股骨颈的BMD低于健康对照组及NDR组〔分别为(0.66±0.15)、(0.76±0.15)、(0.81±0.18)g/cm2〕,差异有统计学意义(P<0.05及P<0.01);前后位腰椎各部位BMD在DR组BMD均高于健康对照组及NDR组(P<0.05)。DR组血清BGP显著低于健康对照组(P<0.01),与NDR组比较,差异无统计学意义(P>0.05);DR组血清PTH、P显著高于NDR组及健康对照组(P<0.05及P<0.01)。结论老年T2DM合并视网膜病变者的股骨近端BMD显著低于无视网膜病变糖尿病患者和健康人群,而腰椎各部位BMD水平则与之相反。
Objective To investigate the changes of bone mineral density (BMD) in elderly patients with type 2 diabetes mellitus (T2DM) complicated with retinopathy. Methods Fifty-six elderly patients with T2DM complicated with diabetic retinopathy (DR group), 60 diabetic patients without T2DM (NDR group) and 58 healthy controls (healthy control group) were enrolled in this study. The femoral neck, greater trochanter, Ward’s trigone ) And anterior and posterior lumbar spine BMD. Serum levels of BGP, Ca, P, PTH and Cr / Cr (Cr )Level. Results The BMD of femoral neck in DR group was significantly lower than that in healthy control group and NDR group [(0.66 ± 0.15) and (0.76 ± 0.15) and (0.81 ± 0.18) g / cm2, respectively] And P <0.01). The BMD of BMD in anterior and posterior lumbar vertebrae in DR group were significantly higher than those in healthy control group and NDR group (P <0.05). Serum BGP in DR group was significantly lower than that in healthy control group (P <0.01), but there was no significant difference between NDR group and NDR group (P> 0.05); PTH and P in DR group were significantly higher than those in NDR group and healthy control group (P < 0.05 and P <0.01). Conclusions BMD in the proximal femur of T2DM patients with T2DM is significantly lower than that of patients without diabetic retinopathy and healthy people, while the BMD of each part of the lumbar spine is opposite.