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2型糖尿病骨折患者骨转换生化指标和骨密度的变化

赵红1,顾定伟1,张柳2,白俊清1,朱艳丽1   

  1. 1. 华北煤炭医学院附属医院
    2. 华北煤炭医学院
  • 收稿日期:2010-04-19 修回日期:2010-08-31 出版日期:2011-01-15 发布日期:2011-01-15
  • 通讯作者: 顾定伟

Changes of biochemical markers of bone turnover and mineral density in fracture patients with type 2 diabetes mellitus

  • Received:2010-04-19 Revised:2010-08-31 Published:2011-01-15 Online:2011-01-15

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摘要： 摘要：目的 通过比较2型糖尿病骨折及非骨折患者骨特异性sBAP、sCTX、uCTX及BMD值特点，探讨2型糖尿病骨折发生机制及骨转换生化指标预测骨折的价值。方法 双能X线骨密度仪测定腰椎椎体（L2-4）和左股骨大转子（Troch）、粗隆间（Ward’s）、股骨颈(Neck)的骨密度; ELASA酶联免疫测定骨转换生化指标sBAP、sCTX、uCTX。结果 2型糖尿病骨折组较非骨折组sBAP明显降低，差异有统计学意义，BMD、sCTX、uCTX未见明显差异。结论 2型糖尿病骨折较非骨折患者成骨细胞活性降低，但骨密度及破骨细胞活性无明显改变，具有更低的骨转换率。骨生化指标可能是预测2型糖尿病骨折的初期指标。

关键词: 糖尿病, 2 型, 骨密度, 骨和骨组织, 骨折, 碱性磷酸酶

Abstract: ABSTRACT: Objective By comparison of the changes of sBAP, sCTX, uCTX bone specific biochemical markers and BMD in 52 bone fracture patients and 89 non-fracture patient with type 2 diabetes to explore the mechanism of bone fracture and biochemical markers for prediction of fracture value in type 2 diabetes patients. Methods Dual-energy X-ray absorption metry was used to measure BMD of lumbar spine (L2-4) and the trochanter (Troch), intertrochanteric (Ward's), femoral neck (Neck) of left hip bones ; ELASA enzyme-linked immunosorbent assay shares biochemical markers sBAP, sCTX, uCTX. Results Age, BMI, HbAc1, BMD have no significant difference between fractures and non-fracture patients with type 2 diabetes mellitus； sBAP(31.6±8.0 vs 38.8±6.3) of the bone specific biochemical markers was lower in fracture group than non-fracture group ,howere, sCTX( 9.8±2.5 vs 8.6±1.7), uCTX (35.2±8.2 vs 32.4±7.6 )as the sign of bone resorption have no differentiation between the two groups Conclusion :In fracture patients of type 2 diabetes, the activity of osteoblasts decrease, but osteoclast activity and bone mineral density don’t significantly change. The bone turnover ratio decrease in fracture patients than non-fracture patients of type 2 diabetes. Bone biochemical markers possibly be the early indicators of fracture of type 2 diabetes.

Key words: Diabetes Mellitus, Type 2, Bone Density, Bone and Bones, Fractures, Bone, Alkaline Phosphatase