Department of Geratology, Shanghai JiaoTong University, Affiliated Sixth People's Hospital, Shanghai 200233, China.
Ann Endocrinol (Paris). 2012 Dec;73(6):546-51. doi: 10.1016/j.ando.2012.09.009. Epub 2012 Nov 2.
Diabetes is often associated with complications and comorbidities. Diabetic osteoporosis (OP) is increasingly recognized as a significant comorbidity of type 2 diabetes mellitus (T2-DM). In this study, we intended to determine whether type 2 diabetes was associated with a higher bone mineral density (BMD) in older males, and investigate the related risk factors of diabetes mellitus accompanied with OP.
To assess the effects of diabetes and its complications on the risk of bone fractures, the daily glycemia, insulin and HbAlc of T2-DM patients were detected. At the same time, Dual Energy X-ray Absorptiometry (DEXA) was used to measure the BMD of whole body, lumbar spine and proximal femoral at 2-year intervals.
The BMD in elderly male patients suffered from T2-DM was associated with kidney function. The decrease of BMD in elderly male patients with T2-DM was related to HbA1c and body mass index (BMI). The BMD in group of renal function insufficiency or clinical albuminuria which are closely related with insulin insufficiency were much lower than that in the group of normal control. Additionally, a significantly lower (P<0.05) T-score was found in patients with nephropathy as compared with those without the complications.
The elderly patients with type 2 diabetes mellitus are prone to develop OP. The insufficiency of insulin, the decreased insulin sensitivity and diabetic nephropathy are important causes for OP in the patients with type 2 diabetes.
糖尿病常伴有并发症和合并症。糖尿病性骨质疏松症（OP）日益被认为是 2 型糖尿病（T2-DM）的一种重要合并症。在本研究中，我们旨在确定 2 型糖尿病是否与老年男性更高的骨密度（BMD）相关，并探讨糖尿病合并 OP 的相关危险因素。
为了评估糖尿病及其并发症对骨折风险的影响，检测了 T2-DM 患者的日常血糖、胰岛素和 HbAlc。同时，每隔 2 年使用双能 X 线吸收法（DEXA）测量全身、腰椎和股骨近端的 BMD。
患有 T2-DM 的老年男性患者的 BMD 与肾功能有关。T2-DM 老年男性患者 BMD 的下降与 HbA1c 和体重指数（BMI）有关。与肾功能不全或与胰岛素不足密切相关的临床蛋白尿组的 BMD 明显低于正常对照组。此外，与无并发症的患者相比，肾病患者的 T 评分明显较低（P<0.05）。
老年 2 型糖尿病患者易发生 OP。胰岛素不足、胰岛素敏感性降低和糖尿病肾病是 2 型糖尿病患者发生 OP 的重要原因。
