血清25( OH )VD水平在2型糖尿病患者中的状况
Analysis of the serum 25 ( OH ) VD level in patients with type 2 diabetes
  
DOI:10.3969/j.issn.1006.7108.2012.08.012
中文关键词:  25( OH )VD  2型糖尿病;骨转换指标
英文关键词:25-( OH ) VD  Type 2 diabetes  Bone turnover biomarker
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作者单位
陈玲 胡肇衡 纪立农 100044北京,北京大学人民医院内分泌代谢科 
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中文摘要:
      目的 糖尿病患者骨质疏松以及骨折的风险较非糖尿病患者增加,在1型糖尿病患者中表现明显,但对于2型糖尿病患者骨折的风险和骨密度的变化存在争议。本研究探讨25( OH )VD和骨转换指标在2型糖尿病患者的变化,分析其对骨代谢的影响。方法 收集2007. 12至2011. 10于我院 就诊的437例未接受维生素D补充治疗的病程不超过5年的2型糖尿病患者(T2DM ),同时收集非糖尿病的对照组(NDM )414例,测定各组患者骨生化指标,并收集临床资料以备数据分析使用。结果 与非糖尿病组患者相比,2型糖尿病患者血清25( OH)VD水平明显降低(P=0. 001 ),骨特异性碱性磷酸酶(BAP)、抗酒石酸酸性磷酸酶(TRAP)水平升高,骨转换活跃;男性、女性2型糖尿病患者血清 25( OH )VD水平均较非糖尿病组降低(P均<0. 001 );相关分析显示,2型糖尿病患者血清25( OH )VD水平与空腹血糖呈负相关,而与糖化血红蛋白、HOMA-IR等无明显相关性。结论 2型糖尿病患者血清25( OH )VD水平明显低于非糖尿病者,且与空腹血糖呈负相关,糖化血红蛋白与25( OH )VD 的相关性不如空腹血糖明显。
英文摘要:
      Objective The risk of osteoporosis and fracture in diabetic patients was higher than that in the non - diabetic patients. This was significant in type I diabetes patients. However, the risk of the fracture and variation of bone mineral density ( BMD ) was controversial. This paper aimed to explore the variations of 25 (OH ) VD level and bone turnover biomarkers in type 2 diabetic patients and to analyze their effects on bone metabolism. Methods Totally 437 type 2 diabetic patients with less than five-year duration and without vitamin D supplement were chosen as subjects. Another 414 non-diabetic patients were chosen as controls.The bone biomarkers were measured. The clinical data were collected to analyze.Results The serum 25(OH ) VD level in diabetic patients was significantly lower than that in the non-diabetic patients ( P =0. 001 ). The serum bone-specific alkaline phosphatase ( BAP ) and tartaric-resistant acid phosphatase(TRAP) were significantly higher than that in the non - diabetics patients. Bone turnover in diabetic patients was active. The serum 25 ( 25 ) VD level decreased both in female and male diabetic patients ( P <0. 001 ). Correlation analysis showed that the 25 ( OH ) VD level was negatively associated with fast blood glucose level. The 25 (OH ) VD level was not associated with glycosylated hemoglobin ( H bA1c ) and HOMA-IR. Conclusion The serum 25( OH ) VD level in type 2 diabetic patients is significantly lower than that in non-diabetic patients. It is negatively associated with fast blood glucose level.Its correlation with glycosylated hemoglobin ( HbA1c ) is less obvious than with fast blood glucose.
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