【摘要】 目的　探讨 2型糖尿病 (T2DM )患者绝经期的骨密度 (BMD)变化及其机制 ,以了解其骨代谢情况及相关因素。　方法　采用双能X线骨密度仪测定 2 0 6例T2DM绝经期妇女及 4 0例年龄、体质指数 (BMI)相匹配的健康者的BMD ,收集相关生化指标 ,并对其与年龄、病程、绝经年限、空腹血糖 (FPG)等及部分骨代谢指标进行多元回归分析。　结果　 2 0 6例T2DM绝经期妇女的BMD较健康者有不同程度下降 ,统计分析发现糖化血红蛋白 (HbA1c)与腰椎 2～ 4 (L2～ 4 )、Ward’s三角、股骨颈、股骨大转子部位的BMD呈负相关 :偏回归系数分别为 - 0 0 12 8(P =0 0 0 0 7)、- 0 0 116 (P=0 0 0 0 1)、- 0 2 2 92 (P =0 0 0 0 1)、- 0 0 173(P =0 0 0 0 7)。餐后 2h血糖 (2hPG)与L2～ 4、Ward’s三角部位的BMD呈负相关 :偏回归系数分别为 - 0 0 2 4 9(P =0 0 0 0 1) ,- 0 0 2 4 9(P =0 0 0 0 1)。空腹胰岛素 (FIns)、餐后 2hC肽 (2hCP)水平与L2～ 4、Ward’s三角、股骨颈部位的BMD呈正相关 :FIns的偏回归系数分别为 0 0 12 8(P =0 0 0 0 1)、0 0 188(P =0 0 0 0 1)、0 0 315 (P =0 0 0 0 1) ;2hCP的偏回归系数分别为 0 0 2 83(P =0 0 0 0 1)、0 0 0 5 2 (P =0 0 0 32 )、0 0 177(P =0 0 0 0 6 )。　结论　T2更多还原

【Abstract】 Objective To investigate the changes in bone mineral density (BMD) and its pathophysiology, so as to study the morbidity and related factors of osteoporosis in postmenopausal women with type 2 diabetes mellitus. Methods The subjects included 206 postmenopausal women with type 2 diabetes mellitus and 40 normal controls. BMD was measured by dual energy X-ray absorptiometry. The correlation of BMD with age, medical history, menopause duration, other factors was analyzed by student’s t-test. Analysis of variance and multiple parameters was used. Results BMD decreased in all 206 postmenopausal women with type T2DM.Except for serum sex-hormone, HbA 1c significantly negatively correlated with BMD of L2～4、Ward’s、Neck、Troch with r values of -0.0128(P=0.0007),-0.0116(P=0.0001),-0.2292(P=0.0001),-0.0173(P=0.0007)repectively. 2 hPG negatively correlated with BMD of L2～4、Ward’s with r values of -0.0249(P=0.0001),-0.0249(P=0.0001), repectively. Meanwhile the changes in BMD of L2～4、Ward’s、Neck correlated positively with FIns, 2 hCP with r values of 0.0128(P=0.0001),0.0188(P=0.0001),0.0315(P=0.0001);0.0283(P=0.0001),0.0052(P=0.0032),0.0177(P=0.0006)repectively. Conclusions The reduction of BMD of postmenopausal women with type 2 diabetes mellitus is associated with the levels of sex hormones, and may be relate with the islet cell hypofunction. Control of blood glucose and protection of islet cell are beneficial to OP patients.更多还原