Levin M E, Boisseau V C, Avioli L V
N Engl J Med. 1976 Jan 29;294(5):241-5. doi: 10.1056/NEJM197601292940502.
To assess the influence of diabetes mellitus on bone metabolism, we measured skeletal mass in the forearms of 35 patients with juvenile diabetes on insulin and 101 stable patients with adult-onset diabetes, on diet alone, insulin, or oral hypoglycemic agents. There was a significant loss of bone mass in both juvenile and adult-onset diabetes (P less than 0.01) as compared to controls matched for age and sex. The decrease was already present in patients with diabetes of less than five years' duration. Bone loss and duration of the diabetes did not correlate; the greatest decrease in bone mass was observed in the patients receiving oral agents. These data are consistent with the hypothesis that the loss of skeletal tissue in diabetes reflects the underlying disease since it occurs early and is not related to severity as evidenced by the need for insulin, to duration, or to treatment with insulin or diet alone.
为评估糖尿病对骨代谢的影响，我们测量了35例接受胰岛素治疗的青少年糖尿病患者以及101例仅通过饮食、胰岛素或口服降糖药治疗的病情稳定的成年糖尿病患者前臂的骨量。与年龄和性别匹配的对照组相比，青少年糖尿病患者和成年糖尿病患者均出现了显著的骨量丢失（P<0.01）。病程不到5年的糖尿病患者就已出现骨量减少。骨量丢失与糖尿病病程无关；接受口服降糖药治疗的患者骨量减少最为明显。这些数据与以下假设一致：糖尿病患者骨骼组织的丢失反映了潜在疾病，因为这种情况在疾病早期就已出现，且与胰岛素使用情况、病程长短或仅采用胰岛素或饮食治疗所反映的疾病严重程度无关。
