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绝经后糖尿病:根据年龄和病程对骨量的不同影响。

Diabetes in postmenopause: different influence on bone mass according to age and disease duration.

作者信息

Hadjidakis D I, Androulakis I I, Mylonakis A M, Sfakianakis M E, Raptis A E, Papaefstathiou A G, Economopoulos T C, Raptis S A

机构信息

Endocrine Unit, 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Centre, Athens University, Attikon and Evgenidion University Hospitals, Athens, Greece.

出版信息

Exp Clin Endocrinol Diabetes. 2009 May;117(5):199-204. doi: 10.1055/s-2008-1080921. Epub 2008 Oct 1.

Abstract

OBJECTIVE

Studies addressing the influence of diabetes mellitus on bone metabolism have yielded conflicting results. The aim of the present study is to investigate the bone mineral density (BMD) status of postmenopausal diabetic women with different ages or diabetes duration.

METHODS

Two hundred postmenopausal women with type 2 diabetes (DM) and 800 postmenopausal healthy women (PMP), serving as control subjects, were studied. Subjects were divided into either 6 groups according to 5 year age segments, or 6 groups according to 5 year segments of diabetes duration. BMD was measured at the femoral neck and at the trochanter major with dual energy X-ray absorptiometry.

RESULTS

Diabetic women studied as a whole, exhibited significantly higher BMD values compared to healthy postmenopausal women at both femoral neck and trochanter. Diabetic women of 48-53, 53-58, 58-63 and 63-68 age groups had significantly higher BMD values than the respective control groups, whereas BMD values of DM 73-78 were significantly lower compared to the PMP 73-78 group at both anatomic sites. When the same diabetic women were divided according to diabetes duration (DUR), groups DUR 6-10 and DUR 11-15 exhibited significantly higher BMD values at both anatomic sites compared to control groups. In contrast, BMD values of group DUR 21-25 were significantly lower only at the femoral neck.

CONCLUSIONS

Type 2 diabetes mellitus' influence on bone metabolism seems to depend on the patient's disease duration and age. The initial positive effect on bone mass appears to be ameliorated as age or disease duration advance. Studies concerning type 2 diabetes and bone mass should take these parameters into account.

摘要

目的

关于糖尿病对骨代谢影响的研究结果相互矛盾。本研究旨在调查不同年龄或糖尿病病程的绝经后糖尿病女性的骨密度(BMD)状况。

方法

对200名绝经后2型糖尿病(DM)女性和800名绝经后健康女性(PMP)进行了研究,后者作为对照对象。受试者根据5岁年龄区间分为6组,或根据糖尿病病程的5年区间分为6组。采用双能X线吸收法测量股骨颈和大转子处的骨密度。

结果

总体而言,糖尿病女性在股骨颈和转子处的骨密度值均显著高于绝经后健康女性。48 - 53岁、53 - 58岁、58 - 63岁和63 - 68岁年龄组的糖尿病女性的骨密度值显著高于各自的对照组,而在两个解剖部位,糖尿病病程73 - 78年组的骨密度值均显著低于绝经后健康女性73 - 78年组。当根据糖尿病病程(DUR)对同一组糖尿病女性进行分组时,病程6 - 10年组和病程11 - 15年组在两个解剖部位的骨密度值均显著高于对照组。相比之下,病程21 - 25年组仅在股骨颈处的骨密度值显著较低。

结论

2型糖尿病对骨代谢的影响似乎取决于患者的病程和年龄。随着年龄增长或病程延长,对骨量的初始积极影响似乎会减弱。关于2型糖尿病和骨量的研究应考虑这些参数。

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