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| 非胰岛素依赖型糖尿病人骨量及钙磷代谢的改变 |
| The alterations of bone mass and calcium-phosphorus metabolism from patients with NIDDM |
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| DOI： |
| 中文关键词: 骨质疏松 非胰岛素依赖型糖尿病 骨量减少 钙磷代谢 胰岛素 |
| 英文关键词:Osteoporosis NIDDM Bone loss Calcium-Phosphorus metabolism Insulin |
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| 中文摘要: |
| 本文对46例NIDDM 病人(男25例，女21例，年龄 51.5±7.5岁)和15例与之相匹配的健
康人测定了BMC、BMD、血清钙、磷、AKP、血糖、FRM和胰岛素，尿中钙、肌酐和Hyp。结果显示NIDDM 患者不论男、女的BMC、BMD均显著低于正常对照组，血清钙、磷正常，提示NIDDM 的骨量降低可能不伴有骨软化，而以骨质疏松为特点。NIDDM 组的 Uca/Uer明显升高(0.23±0.21比0.14±0.08，P<0.05)，并且与血糖和血清果糖胺浓度呈正相关“r=0.32和0.41，P<0.05)，提示NIDDM出现骨量降低与高尿钙有关，而且高血糖引起高尿糖状态所致渗透性利尿很可能是高尿钙的主要原因之一。因此，有效地控制高血糖,将减少尿中钙、磷的丢失并预防 N1DDM 患者骨质疏松的发生。本研究还发现NIDDM患者 BMD与 FBG无关( r=0.19，P>0.05)，与 FRM 呈负相关(r=-0.26，P<0.05)，与 INS呈正相关(r=0.29，P<0.05),提示残余的INS分泌量和代谢控制的质量是影响NIDDM患者骨量的主要因素。所以，本研究认为良好的糖尿病控制，特别是予以适量胰岛素，对NIDDM患者骨质疏松确有益处。 |
| 英文摘要: |
| BMC and BMD, the serum levels of Ca，P，AKP，GLU，FRM and INS, the urinary levels of Ca, Cr and Hyp from 46 patients with NIDDM (male 25，female 21，age 51.5±7.5yrs)and 46 age-and sex-matched controls were measured. The results showed that the BMC and BMD from the diabetics, both males and females, reduced compared with those from the controls．The serum Ca and P were normal in both groups. These indicate that the decrease in BMC and BMD from the diabetics may result from osteoporosis rather than osteomalacia．Uca/Ucr in the diabetic group was significantly higher than that in the control(0.23± 0.21 vs0.14± 0.08,P< 0.05),and positively correlated with the concentrations of blood glucose and FRM (r=0.32and 0.41,P<0.05)，indicating that bone Ioss in diabetics relate to hypercalcinuria．Osmotic diuresis caused by hyperglycemia may be one of the major factors for hypercalcinuria. Good control of hyperglycemia，therefore，will decrease calcium and phosphorus loss from urine and prevent osteoporosis in the patients with NIDDM ．The results ，also, showed that the BMD from the diabetics had no correlation with the levels of BGs(r=0.19,P>0.05)，and had negative correlation with the levels of FRM (r=-0.26,P< 0.05), positive correlation with the levels of FINS(r= 0.29，P<0.05). The results indicate that the impaired ability of insulin secretion of βcells and poor control of hyperglycemia may be responsible for the bone mass loss，suggesting optimal diabetic control，especially adequate insulin administration，is certainly beneficial for osteoporosis in patients with NIDDM. |
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