中青年男性2型糖尿病患者病程与骨密度及骨代谢生化指标相关性研究
发布时间：2018-07-31 16:58
【摘要】：目的:糖尿病在全世界范围内是一种高发病率的全身慢性内分泌代谢性疾病,其晚期并发症除常见的大血管病变及微血管病变外,还有骨代谢异常引起的病变,严重者可导致骨质疏松的发生。目前的研究显示1型糖尿病对骨代谢的影响并无太大争议,已得到了大部分业内人士的认可,但是2型糖尿病对骨代谢的影响无统一的定论,对其的相关研究也一直在不断深入。骨代谢生化指标可在一定程度上反映人体正在发生的骨转换速率并可预测将来骨量变化的趋势,对选择干预治疗骨质疏松的用药提供一定的指导作用。目前的研究显示骨钙素、骨碱性磷酸酶等与骨形成有关且呈正相关关系,I型胶原C末端肽等与骨吸收有一定的关系且呈负相关。本研究通过测定中青年男性2型糖尿病患者骨密度及相关骨代谢生化指标,以揭示不同病程的中青年男性2型糖尿病患者的病程对骨密度及相关骨代谢生化指标的影响。方法:本研究收集在南昌大学第三附属医院内分泌科2013年8月-2014年8月住院的中青年男性2型糖尿病患者80例,根据病程不同设置A、B两组平行对照组,入组人数相同,即40例病程在5年以内的为A组,40例病程在5-10年的为B组。所有患者入组时均需常规测量身高和体重,计算患者的体重指数(Body mass index BMI)。收集所有患者的血清标本,采用酶联免疫吸附(Enzyme linked immunosorbant assay,ELISA)法检测血清骨钙素、血清25(OH)D3、血清I型胶原羧基末端肽(Type I collagen peptide C,CTX)水平,同时常规检测糖化血红蛋白(Glycosylated haemoglobin,Hb A1c)、骨碱性磷酸酶(Bone alkaline phosphatase)、甲状旁腺素(Parathyroid hormone)、血钙(Calcium)、血磷(Phosphorus)、骨密度(Bone Mineral Density,BMD)。结果:1、病程5-10年的中青年男性2型糖尿病患者较病程小于5年的中青年男性2型糖尿病患者骨密度显著降低(P0.01)。2、病程5-10年的中青年男性2型糖尿病患者的骨钙素、25(0H)D3水平低于病程小于5年的中青年男性2型糖尿病患者(P0.05)。3、病程5-10年的中青年男性2型糖尿病患者的血清I型胶原羧基末端肽水平显著高于病程小于5年的中青年男性2型糖尿病患者(P0.05)。结论:随着2型糖尿病病程延长,骨吸收增加,骨形成下降。骨钙素、25(0H)D3、骨碱性磷酸酶、血清I型胶原羧基末端肽等激素分泌及代谢失常,可能参与了骨质疏松的发生发展。
[Abstract]:Objective: diabetes mellitus is a chronic endocrine and metabolic disease with high incidence all over the world. In addition to the common macroangiopathy and microangiopathy, the late complications of diabetes mellitus are also caused by abnormal bone metabolism. Severe cases can lead to osteoporosis. Current research shows that the effect of type 1 diabetes on bone metabolism is not too controversial and has been recognized by most people in the industry, but there is no uniform conclusion on the effect of type 2 diabetes on bone metabolism. Its related research has also been in depth. The biochemical indexes of bone metabolism can reflect the rate of bone turnover and predict the trend of bone mass change in the future to a certain extent, and provide some guidance for the choice of drugs for intervention in the treatment of osteoporosis. Recent studies have shown that osteocalcin, bone alkaline phosphatase and so on are positively correlated with bone formation. Type I collagen C-terminal peptide is negatively correlated with bone resorption. In this study, bone mineral density (BMD) and related bone metabolism biochemical indexes were measured in young and middle-aged male patients with type 2 diabetes, in order to reveal the effect of the course of disease on bone mineral density and related bone metabolism in young and middle-aged male patients with type 2 diabetes. Methods: a total of 80 young and middle-aged male patients with type 2 diabetes were enrolled in the Endocrinology Department of the third affiliated Hospital of Nanchang University from August 2013 to August 2014. In other words, 40 cases with disease course within 5 years were group A and 40 cases with disease course of 5 to 10 years were group B. All patients were required to routinely measure their height and weight and calculate their body mass index (Body mass index BMI).) when they entered the group. Serum levels of osteocalcin, serum 25 (OH) D3 and type I collagen carboxyl terminal peptide (Type I collagen peptide CT-CTX) were detected by enzyme-linked immunosorbent assay (Elisa) in all patients. At the same time, Glycosylated haemoglobin (HB A 1c), bone alkaline phosphatase (Bone alkaline phosphatase), parathyroid hormone (Parathyroid hormone), serum calcium (Calcium), phosphorus (Calcium), bone mineral density (Bone Mineral density). Results the bone mineral density (BMD) of type 2 diabetes mellitus in young and middle-aged male patients with disease course of 5-10 years was significantly lower than that in young and middle-aged male patients with type 2 diabetes mellitus of less than 5 years (P0.01) .2and osteocalcin 25 (0H) D3 in young and middle-aged male patients with type 2 diabetes mellitus with the course of 5-10 years was significantly lower than that in type 2 diabetes patients with disease course of 5-10 years. The level of serum carboxyl terminal peptide of type I collagen in young and middle-aged men with disease course less than 5 years was significantly higher than that in young men with disease course less than 5 years (P0.05) .3The level of carboxyl terminal peptide of type I collagen in young and middle-aged men with disease course of 5-10 years was significantly higher than that of young men with less than 5 years course. Type 2 diabetes mellitus (P0.05). Conclusion: with the prolongation of the course of type 2 diabetes mellitus, bone resorption increases and bone formation decreases. Osteocalcin 25 (0H) D3, bone alkaline phosphatase, serum type I collagen carboxyl terminal peptide and other hormones secretion and metabolic disorders, may be involved in the occurrence and development of osteoporosis.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R580
[Abstract]:Objective: diabetes mellitus is a chronic endocrine and metabolic disease with high incidence all over the world. In addition to the common macroangiopathy and microangiopathy, the late complications of diabetes mellitus are also caused by abnormal bone metabolism. Severe cases can lead to osteoporosis. Current research shows that the effect of type 1 diabetes on bone metabolism is not too controversial and has been recognized by most people in the industry, but there is no uniform conclusion on the effect of type 2 diabetes on bone metabolism. Its related research has also been in depth. The biochemical indexes of bone metabolism can reflect the rate of bone turnover and predict the trend of bone mass change in the future to a certain extent, and provide some guidance for the choice of drugs for intervention in the treatment of osteoporosis. Recent studies have shown that osteocalcin, bone alkaline phosphatase and so on are positively correlated with bone formation. Type I collagen C-terminal peptide is negatively correlated with bone resorption. In this study, bone mineral density (BMD) and related bone metabolism biochemical indexes were measured in young and middle-aged male patients with type 2 diabetes, in order to reveal the effect of the course of disease on bone mineral density and related bone metabolism in young and middle-aged male patients with type 2 diabetes. Methods: a total of 80 young and middle-aged male patients with type 2 diabetes were enrolled in the Endocrinology Department of the third affiliated Hospital of Nanchang University from August 2013 to August 2014. In other words, 40 cases with disease course within 5 years were group A and 40 cases with disease course of 5 to 10 years were group B. All patients were required to routinely measure their height and weight and calculate their body mass index (Body mass index BMI).) when they entered the group. Serum levels of osteocalcin, serum 25 (OH) D3 and type I collagen carboxyl terminal peptide (Type I collagen peptide CT-CTX) were detected by enzyme-linked immunosorbent assay (Elisa) in all patients. At the same time, Glycosylated haemoglobin (HB A 1c), bone alkaline phosphatase (Bone alkaline phosphatase), parathyroid hormone (Parathyroid hormone), serum calcium (Calcium), phosphorus (Calcium), bone mineral density (Bone Mineral density). Results the bone mineral density (BMD) of type 2 diabetes mellitus in young and middle-aged male patients with disease course of 5-10 years was significantly lower than that in young and middle-aged male patients with type 2 diabetes mellitus of less than 5 years (P0.01) .2and osteocalcin 25 (0H) D3 in young and middle-aged male patients with type 2 diabetes mellitus with the course of 5-10 years was significantly lower than that in type 2 diabetes patients with disease course of 5-10 years. The level of serum carboxyl terminal peptide of type I collagen in young and middle-aged men with disease course less than 5 years was significantly higher than that in young men with disease course less than 5 years (P0.05) .3The level of carboxyl terminal peptide of type I collagen in young and middle-aged men with disease course of 5-10 years was significantly higher than that of young men with less than 5 years course. Type 2 diabetes mellitus (P0.05). Conclusion: with the prolongation of the course of type 2 diabetes mellitus, bone resorption increases and bone formation decreases. Osteocalcin 25 (0H) D3, bone alkaline phosphatase, serum type I collagen carboxyl terminal peptide and other hormones secretion and metabolic disorders, may be involved in the occurrence and development of osteoporosis.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R580
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