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| 抗骨质疏松药物对糖皮质激素导致的骨质疏松症患者 骨代谢与糖代谢平衡影响的研究 |
| Effect anti-osteoporotic drugs on the bone homeostasis of bone and glucose metabolism in patients with glucocorticoid-induced osteoporosis |
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| DOI： |
| 中文关键词: 糖皮质激素 骨质疏松 糖代谢 抗骨质疏松药 骨钙素 |
| 英文关键词: |
| 基金项目: |
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| 摘要点击次数: 1193 |
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| 中文摘要: |
| 目的研究抗骨质疏松药物对糖皮质激素诱导的骨质疏松症患者血糖稳态的影响。方法选取20TO年8月至2012 年8月于本院诊断为骨质疏松症且符合人组标准的122例患者为研究对象。随机将患者分为阿伦膦酸盐组，特立帕肽组，钙 制剂和维生素D组。比较并分析三组患者应用抗骨质疏松药物前后血糖水平(空腹血糖、糖化血红蛋白）和骨代谢水平（P淑 原特殊序列、骨钙素）变化情况。结果32名（26.2%)患者的骨钙素（OC)初始值水平低于正常标准。56名（45.9%)患者， 根据其血糖初始值水平，诊断为糖耐量异常或糖尿病。B组患者应用特立帕肽一年后的空腹血糖（FBG) (5. 2 ±0.8 mmolj) 显著低于初始值(5. 6 ±1.0 mmol/L) (P = 0. 049);—年后的糖化血糖蛋白（HbAlc)水平(5. 3 ± 1. 0% )显著低于初始值(5. 9 士 1. 3%)P = 0. 021)。且B组患者一年后糖耐量异常患者比例（7. 3%)较初始比例（24. 3% )显著下降（P = 0. 033 )；糖尿病 (4.8%)比例较初始比例(21. 9%)亦显著下降(P =0.023)。A、B、C三组患者应用抗骨质疏松药物6个月及1年后，^胶原 特殊序列（P-CTx)水平均显著低于初始值(P值均< 0. 05);而OC水平均显著高于初始值(P值均< 0. 05)。B组应用抗骨质 疏松药物1年后，其OC水平（16. 4 ±0.9略/)显著高于同期A组（15.9±1.1略/)、C组（15.7±0.9略/)的OC水平（P值 分别为0. 027，0. 001)。结论初步认为骨形成促进剂类抗骨质疏松药物（特立帕肽）可以对糖皮质激素诱导的骨质疏松患 者的糖代谢平衡产生一定影响，但仍然需要更完善的实验去提供更多的循证依据。 |
| 英文摘要: |
| Objective To investigate the effects of anti-osteoporotic on glucose homeostasis in patients with glucocorticoid- induced osteoporosis. Methods Patients with osteoporosis who met the inclusion criteria (n = 122) in our hospital between August 2009 and August 2012 were recruited. They were divided into alendronate group (A)，teriparatide group (B)，and calcium and vitamin D group (C) randomly. Blood glucose levels (FBG and HbAlc) and bone turnover levels ( p-CTX and OC) were compared and analyzed before and after the treatment. Results OC value was below the reference range in 32 patients (26. 2% ) at the initial time of the study. Fifty-six patients (45.9%) were diagnosed as glucose tolerance disorder or diabetes mellitus according to their initial blood glucose level. The level of FBG (5. 2 ±0. 8 mmol/L) in B group after 1-year treatment was significant lower than that before the treatment (5. 6 ± 1. 0 mmol/L，P = 0. 049). In B group，the level of HbAlc (5. 3 ± 1. 0% ) after 1-year treatment was significant lower than that before the treatment experiment (5.9±1.3%，P =0. 021). The ratio of impaired glucose tolerance in patients and diabetes mellitus decreased significantly (24. 3% to 7. 3%，P =0. 033 ； 21. 9% to 4. 8%， P =0. 023，respectively). (3-CTX level after 6 months and 1 year treatment was significantly lower than that before the treatment in A，B，and C group (p < 0. 05)，but OC level was higher (p < 0. 05). OC level in B group (16. 4 ± 0. 9 jxg^l) was higher than that in group A (15. 9 ±1. 1 jxg^l) and C (15. 7 ±0. 9 jxg^l) after 1-year treatment ( P = 0. 027 and P =0. 001，respectively). |
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