2型糖尿病对骨折患者骨转换生化指标及骨密度的影响(1)
【摘要】 目的：了解2型糖尿病(T2DM)患者合并骨折的骨转换状态及骨密度变化。方法：选取2016年4月-2018年5月在笔者所在医院骨科住院行手术治疗的70岁以下男性骨折患者149例，根据患者血糖情况分为非糖尿病骨折组(82例)及2型糖尿病骨折组(67例)，观察两组患者部位骨密度(BMD)、血骨特异性碱性磷酸酶(BAP)及尿脱氧吡啶啉(DPD)与尿肌酐比值等指标的变化。结果：2型糖尿病骨折组TALP、BAP均低于非糖尿病骨折组，DPD/Cr高于非糖尿病骨折组，差异均有统计学意义(P<0.05);两组不同部位骨密度比较差异无统计学意义(P>0.05)。结论：2型糖尿病可影响骨质代谢，从而可能影响骨折的愈合;骨转换生化指标变化早于骨密度，较骨密度敏感，可在临床用于2型糖尿病合并骨折的诊断。
【关键词】 2型糖尿病 骨折 骨转换 骨密度
doi：10.14033/j.cnki.cfmr.2020.21.057 文献标识码 B 文章编号 1674-6805(2020)21-0-03
Effect of Type 2 Diabetes Mellitus on Bone Turnover Biochemical Index and Bone Mineral Density in Patients with Fracture/KAN Weijun， LIU Hongxing， ZHANG Liping， WANG Ping， XUE Shan， HU Cuifen. //Chinese and Foreign Medical Research， 2020， 18(21)： -140
[Abstract] Objective： To investigate the bone transition status and bone mineral density changes in patients with type 2 diabetes mellitus (T2DM) complicated with fractures. Method： A total of 149 male fracture patients under the age of 70 who underwent surgical treatment in the department of orthopedics in our hospital from April 2016 to May 2018 were selected， patients were divided into the non-diabetic fracture group (82 cases) and the type 2 diabetic fracture group (67 cases) according to their blood glucose. The changes of bone mineral density (BMD)， bone specific alkaline phosphatase (BAP) and urine deoxypyridine (DPD) in the two groups were observed. Result： The TALP and BAP in the type 2 diabetic fracture group were lower than those in the non-diabetic fracture group， and DPD/Cr was higher than that in the non-diabetic fracture group， the differences were statistically significant (P<0.05). There was no significant difference in BMD between the two groups (P>0.05). Conclusion： Type 2 diabetes affect bone metabolism and may affect fracture healing. The change of biochemical index of bone transformation is earlier than BMD and more sensitive than BMD， which can be used in the diagnosis of type 2 diabetes complicated with fracture clinically.
[Key words] Type 2 diabetic mellitus Fracture Bone turnover Bone mineral density
First-author’s address： Shanxi Army Hospital， Taiyuan 030006， China
隨着人们生活水平的提高，糖尿病的发病率也越来越高。目前临床研究发现，糖尿病不仅有可能引发一系列慢性疾病，更有可能导致患者发生骨折，同时这种骨折治愈难度较高，在临床中成为普遍的难题。而我国现阶段早已成为糖尿病大国，总体糖尿病患病率居高不下[1]。现有多种学说，而高血糖对骨骼的直接影响认为是最重要的。本文选取2016年4月-2018年5月在笔者所在医院骨科住院行手术治疗的70岁以下男性骨折患者149例，根据患者血糖情况分成血糖正常骨折组和糖尿病骨折组，观察2型糖尿病骨折及非糖尿病骨折患者骨密度(BMD)、血骨特异性碱性磷酸酶(BAP)及尿脱氧吡啶啉(DPD)等指标的变化，探讨2型糖尿病骨折发生机制及骨转换生化指标的预测价值，具体如下。, 百拇医药(阚卫军 刘红星 张丽萍 王苹 薛珊 胡翠芬)
【关键词】 2型糖尿病 骨折 骨转换 骨密度
doi：10.14033/j.cnki.cfmr.2020.21.057 文献标识码 B 文章编号 1674-6805(2020)21-0-03
Effect of Type 2 Diabetes Mellitus on Bone Turnover Biochemical Index and Bone Mineral Density in Patients with Fracture/KAN Weijun， LIU Hongxing， ZHANG Liping， WANG Ping， XUE Shan， HU Cuifen. //Chinese and Foreign Medical Research， 2020， 18(21)： -140
[Abstract] Objective： To investigate the bone transition status and bone mineral density changes in patients with type 2 diabetes mellitus (T2DM) complicated with fractures. Method： A total of 149 male fracture patients under the age of 70 who underwent surgical treatment in the department of orthopedics in our hospital from April 2016 to May 2018 were selected， patients were divided into the non-diabetic fracture group (82 cases) and the type 2 diabetic fracture group (67 cases) according to their blood glucose. The changes of bone mineral density (BMD)， bone specific alkaline phosphatase (BAP) and urine deoxypyridine (DPD) in the two groups were observed. Result： The TALP and BAP in the type 2 diabetic fracture group were lower than those in the non-diabetic fracture group， and DPD/Cr was higher than that in the non-diabetic fracture group， the differences were statistically significant (P<0.05). There was no significant difference in BMD between the two groups (P>0.05). Conclusion： Type 2 diabetes affect bone metabolism and may affect fracture healing. The change of biochemical index of bone transformation is earlier than BMD and more sensitive than BMD， which can be used in the diagnosis of type 2 diabetes complicated with fracture clinically.
[Key words] Type 2 diabetic mellitus Fracture Bone turnover Bone mineral density
First-author’s address： Shanxi Army Hospital， Taiyuan 030006， China
隨着人们生活水平的提高，糖尿病的发病率也越来越高。目前临床研究发现，糖尿病不仅有可能引发一系列慢性疾病，更有可能导致患者发生骨折，同时这种骨折治愈难度较高，在临床中成为普遍的难题。而我国现阶段早已成为糖尿病大国，总体糖尿病患病率居高不下[1]。现有多种学说，而高血糖对骨骼的直接影响认为是最重要的。本文选取2016年4月-2018年5月在笔者所在医院骨科住院行手术治疗的70岁以下男性骨折患者149例，根据患者血糖情况分成血糖正常骨折组和糖尿病骨折组，观察2型糖尿病骨折及非糖尿病骨折患者骨密度(BMD)、血骨特异性碱性磷酸酶(BAP)及尿脱氧吡啶啉(DPD)等指标的变化，探讨2型糖尿病骨折发生机制及骨转换生化指标的预测价值，具体如下。, 百拇医药(阚卫军 刘红星 张丽萍 王苹 薛珊 胡翠芬)