肾功能正常的男性2型糖尿病并发白蛋白尿患者骨密度变化
Change of bone mineral density in male type 2 diabetes mellitus patients with normal renal function complicated with albuminuria
  
DOI:10.3969/j.issn.1006-7108.2016.10.014
中文关键词:  2型糖尿病  男性  白蛋白尿  骨密度
英文关键词:Type 2 diabetes mellitus  Male  Albuminuria  Bone mineral density
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杜云峰* 赵丹 赵镇 叶新华 成金罗 南京医科大学附属常州市第二人民医院内分泌代谢科江苏常州 213000 
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中文摘要:
      目的 分析男性2型糖尿病(T2DM)并发白蛋白尿但肾功能正常患者的骨密度(BMD)变化。方法 本研究为回顾性分析,纳入202例肾功能正常的男性T2DM患者和99例男性健康对照者(A组)。T2DM患者根据尿白蛋白与肌酐比值(UACR)分为正常白蛋白尿组(B组)、微量白蛋白尿组(C组)及大量白蛋白尿组(D组)。采用双能X线吸收法(DXA)测量所有受试者腰椎及髋部BMD值。结果 B组、C组腰椎BMD较A组升高(P < 0.05);D组腰椎BMD较A有升高趋势,较B组、C组间有降低趋势,但差异均无统计学意义(P >0.05)。大转子区(Troch)、转子间区(Inter)、髋部总体区(Total Hip)BMD在B组、C组较A组升高(P < 0.05),在D组较A、B、C组间均有升高趋势,但差异无统计学意义(P >0.05)。股骨颈区(Neck)、Ward三角区(Ward) BMD在4组间差异无统计学意义(P >0.05)。L1-4BMD和Total Hip BMD在C较B组有升高趋势,但差异无统计学意义(P >0.05)。结论 男性T2DM患者BMD较健康人群升高,并发微量白蛋白尿时BMD可能继续升高,出现大量白蛋白尿后腰椎BMD有回降趋势,而髋部BMD有进一步升高趋势。
英文摘要:
      Objective To analyze the change of bone mineral density (BMD) in male type 2 diabetes mellitus (T2DM) patients with normal renal function complicated with albuminuria. Methods The study is a retrospective analysis, 202 male T2DM patients with normal renal function and 99 male healthy controls (group A) were enrolled. According to a urine albumin-to-creatinine ratio (UACR), T2DM patients were categorized into three groups: normal albuminuria group (group B), microalbuminuria group (group C) and macroalbuminuria group (group D). BMD were measured by dual energy X-ray absorptiometry (DXA). Results BMD of lumbar spine in group B and group C was higher than that in group A (P<0.05), and this parameter in group D had a non-significant trend of higher than that in group A (P>0.05) but lower than that in group B and group C (P>0.05). BMD of Trochanter, Intertrochanter and Total Hip in group B and group C was higher than that in group A (P<0.05), and this parameter in group D had a non-significant trend of higher than that in group A, group B and group C (P>0.05). BMD of lumbar and Total Hip in group C had a non-significant trend of higher than that in group B (P>0.05). Conclusion BMD of male T2DM patients was higher than that of healthy population, and it may continue to increase with appearance of microalbuminuria. However, BMD of lumbar spine may begin to decrease and BMD of hip may continue to increase after emergence of macroalbuminuria.
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