Bone metabolism in male patients with type 2 diabetes
Bone metabolism in male patients with type 2 diabetes
复制标题
DOI：
10.1007/s10067-004-1070-9
复制
发表时间：
2005-09-01
影响因子：
3.4
通讯作者：
El Maghraoui, A
中科院分区：
文献类型：
--
作者：
Achemlal, L;Tellal, S;El Maghraoui, A
关于2型糖尿病骨转换的报道很少。2型糖尿病患者骨转换受损似乎是由于骨形成减少所致。研究还表明，2型糖尿病患者血糖控制不良可能导致骨质疏松症。本研究的目的是调查控制不佳的2型糖尿病男性患者骨转换的生化标志物，并寻找与血糖控制和性腺及垂体激素轴的相关性。研究对象为连续6个月内在内科就诊的2型糖尿病控制不佳的男性患者。患者正在接受口服降糖药（二甲双胍或磺脲类或两者）。所有患者均无任何大血管病变、肾病或神经病变的证据。只有两名患者有增殖性视网膜病变。检测35例患者和35例对照组血清骨钙素、交联蛋白（C-端肽，CTx）、甲状旁腺激素（PTH）、睾酮、雌激素、催乳素、卵泡刺激素（FSH）和黄体生成素（LH）。研究人群的平均年龄为53.7（10.3）岁（范围：50.2-57.3），平均病程为8.6（6.0）年（范围：6.5-10.7）。患者和对照组之间在血清钙、磷、肌酐、白蛋白、PTH、CTx、雌激素、睾酮、LH、FSH、催乳素和尿钙方面没有观察到差异。患者血清骨钙素水平低于对照组，差异有统计学意义[ 15.3（4。1)对比18.3（5.3），p = 0.012]。CTx水平与HbA 1c呈显著负相关（r=-0.41，p < 0.05）。我们的研究表明，2型糖尿病患者骨形成改变，骨转换受血糖控制状态的影响。
Few reports are available on bone turnover in type 2 diabetes. Impaired bone turnover in type 2 diabetes appears to result from decreased bone formation. Studies also suggest that poor glycaemic control in type 2 diabetes may contribute to osteopaenia. The aim of this study was to investigate biochemical markers of bone turnover in males with poorly controlled type 2 diabetes and look for correlations with glycaemic control and gonadal and hypophyseal hormonal axis. Consecutive male patients with poorly controlled type 2 diabetes and attending the internal medicine department during a period of 6 months were enrolled. The patients were receiving oral hypoglycaemic agents (metformin or sulphonylureas or both). None of the patients had any evidence of macroangiopathy, nephropathy or neuropathy. Only two patients had proliferative retinopathy. Serum osteocalcin, crosslaps (C-telopeptide, CTx), parathyroid hormone (PTH), testosterone, oestrogen, prolactin, follicle-stimulating hormone (FSH) and luteinising hormone (LH) were measured in 35 patients and 35 controls. The mean age of the study population was 53.7 (10.3) years (range: 50.2-57.3) and the mean disease duration was 8.6 (6.0) years (range: 6.5-10.7). No differences between patients and controls were observed in serum calcium, phosphorus, creatinine, albumin, PTH, CTx, oestrogen, testosterone, LH, FSH, prolactin and urinary calcium. Patients had lower serum levels of osteocalcin than controls with a significant statistical difference [ 15.3 (4. 1) vs 18.3 (5.3), p = 0.012]. There was a negative significant statistical correlation between CTx levels and HbA1c (r=-0.41, p< 0.05). Our study suggested that bone formation is altered in type 2 diabetes and that bone turnover is affected by glycaemic control status.