2型糖尿病患者骨密度及骨代谢指标与糖尿病视网膜病变相关性的研究
Study on the correlation between bone mineral density and bone metabolic markers indexes and diabetic retinopathy in patients with type 2 diabetes mellitus
  
DOI:10.3969/j.issn.1006-7108.2021.09.003
中文关键词:  2型糖尿病  糖尿病视网膜病变  骨密度  骨代谢指标
英文关键词:type 2 diabetes mellitus  diabetic microangiopathy  bone mineral density  bone metabolic markers
基金项目:深圳市科创委知识创新计划基础研究项目专项课题(深发改[2017]1447);重大慢性非传染性疾病防控研究(2017YFC1310704);广东省高水平医院重点建设医院专项(粤办函[2019]260号)
作者单位
谭晓霞1,2 洪丽荣1 谢凤2 曾庆祥2 连晓芬1 黄政杰2 张帆1* 1.北京大学深圳医院内分泌科广东 深圳 518000 2.汕头大学医学院临床医学系广东 汕头 515041 
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中文摘要:
      目的 探究2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨密度(bone mineral density,BMD)、骨代谢指标及骨量异常情况与糖尿病视网膜病变(diabetic retinopathy,DR)的关系,为T2DM患者骨健康提供科学依据。方法 入选2018年12月至2019年12月北京大学深圳医院内分泌科收治的T2DM患者,根据是否合并DR分为无DR组和DR组,比较2组间的性别、年龄、糖尿病病程、BMI、吸烟/饮酒史、BMD、骨代谢指标及骨量异常患病情况。结果 总纳入T2DM患者616例,无DR组452例,DR组164例。与无DR组相比,DR组糖尿病病程较长,腰椎L1~L4、股骨及股骨颈BMD、T值、Z值均偏低,血Ca、24 h尿Ca、25(OH)D3 偏低及血P、β-CTX偏高。T2DM合并视网膜病变骨量异常患病率偏高(59.8 % vs 50.2 %,OR=1.48;95 %CI: 0.99~2.22)。结论 T2DM患者合并视网膜病变时骨形成及骨吸收指标表达均升高,骨转换率加速,PTH升高,破骨细胞活性增强,BMD下降,骨量异常患病率偏高。
英文摘要:
      Objective To investigate the correlation between bone mineral density (BMD) and bone metabolic markers indexes and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM), and to provide scientific evidence for bone health for T2DM patients. Methods Our study included 616 T2DM patients admitted to the Department of Endocrinology of Peking University Shenzhen Hospital from December 2018 to December 2019. Patients were divided into non-DR group (452 patients without DR) and DR group (164 patients with DR) to compare the gender, age, course of diabetes, BMI, smoking/drinking history, BMD, and bone metabolic markers indexes. Results Compared to those in non-DR group, the course of diabetes was higher, BMD values of T- and Z-score of the lumbar vertebrae L1-L4, the femur, and the femoral neck were lower, the levels of bone metabolic markers (Ca, 24h urine Ca, and 25(OH)D3) were lower, and the levels of bone metabolic markers (P and β-CTX) were higher in DR group. The prevalence of abnormal bone mass in T2DM patients with diabetic retinopathy was higher (59.8% vs 50.2%, OR=1.48; 95%CI: 0.99-2.22). Conclusion When T2DM patients are complicated with DR, the expressions of bone formation markers and bone resorption markers increase, the rate of bone turnover accelerates, the level of PTH and the activity of osteoclasts increase, BMD decreases, and the prevalence of abnormal bone mass increases.
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