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目的 探讨２型糖尿病对骨代谢紊乱及相关激素的影响。方法 测定２０例健康对照者和６０例２型糖尿病患者血甲状旁腺激素（ＰＴＨ）、降钙素（ＣＴ）、２５羟维生素Ｄ３ 〔２５（ＯＨ）Ｄ３〕、环磷酸腺苷（ｃＡＭＰ）和血、尿钙（Ｃａ）、磷（Ｐ）、镁（Ｍｇ）、糖基化血红蛋白（ＨｂＡ１ｃ）、２４小时尿糖、Ｃ肽曲线下面积等指标。结果 ①２型糖尿病患者血ＰＴＨ 水平显著高于对照组（Ｐ＜ ０．００１和Ｐ＜ ０．０１），ＣＴ水平显著低于对照组（Ｐ＜ ０．０１），尿Ｃａ、尿Ｍｇ 排泄量显著高于对照组（Ｐ＜ ０．０１和Ｐ＜ ０．０５）；②ＰＴＨ水平与ＨｂＡ１ｃ和尿Ｃａ 呈显著正相关（ｒ＝ ０．４０，Ｐ＜ ０．０５和ｒ＝ ０．８３，Ｐ＜ ０．００１），与ＣＴ呈显著负相关（ｒ＝ － ０．７４， Ｐ＜ ０．０１）；③ＰＴＨ水平与Ｃ肽曲线下面积呈负相关（ｒ＝ － ０．３１， Ｐ＜ ０．２）。结论 ２型糖尿病患者存在明显Ｃａ、Ｍｇ 代谢异常和继发性ＰＴＨ、ＣＴ改变是造成骨质疏松的主要原因，这种变化在糖尿病早期更明显。血糖控制不良可促进其发展
Objective To investigate the effects of type 2 diabetes on disorders of bone metabolism and related hormones. Methods The levels of parathyroid hormone (PTH), calcitonin (CT), 25hydroxyvitamin D3 (25 (OH) D3), cAMP in 20 healthy controls and 60 patients with type 2 diabetes mellitus Blood, Ca, P, Mg, HbA1c, 24-hour urine sugar, C-peptide area under the curve. Results ① The level of PTH in type 2 diabetic patients was significantly higher than that in control group (P <0.001 and P <0.01), and the level of CT was significantly lower than that in control group (P <0.01) (P <0.01 and P <0.05). ② The level of PTH was positively correlated with HbA1c and urine Ca (r = 0.40, P <0.05 and r = 0.83, P < 0.001), and negatively correlated with CT (r = - 0.74, P <0.01). ③The level of PTH was negatively correlated with the area under the C peptide curve (r = - 0.31, P <0.2 ). Conclusion There are obvious Ca and Mg metabolism abnormalities and secondary PTH in patients with type 2 diabetes. The changes of CT are the main causes of osteoporosis. This change is more obvious in the early stage of diabetes. Poor blood glucose control can promote its development