Hough F S
S Afr Med J. 1987 Jul 18;72(2):120-6.
This study reports a 22% prevalence of significant cortical osteopenia in 206 patients, aged 7-20 years, with established insulin-dependent diabetes mellitus (IDDM). A parallel decrease in trabecular bone mass was also noted. Bone loss was more evident in males (16%) than in females (6%) and was rare before 10 years of age (3%). No relationship between bone loss and the duration of diabetes, degree of metabolic control or diabetic complications was apparent. Delayed skeletal maturation did not account for cortical thinning, and the mean bone age of osteopenic diabetics was similar to that of non-osteopenic diabetics. There was no significant correlation between HLA-antigen frequency and the predisposition to diabetic osteopenia. Metabolic alterations comparable with previous findings in the chronically diabetic rat were documented in IDDM. The data documented are consistent with the conclusion that IDDM results in intestinal hyperabsorption of calcium, absorptive hypercalciuria, phosphaturia, hypomagnesaemia, hyperphosphatasaemia, and decreased circulating parathyroid hormone levels. These alterations in mineral metabolism may relate to the decrease in cortical and trabecular bone mass observed in patients with IDDM.
本研究报告了206例7至20岁确诊为胰岛素依赖型糖尿病（IDDM）患者中，显著皮质骨量减少的患病率为22%。同时也注意到小梁骨量平行下降。男性（16%）的骨质流失比女性（6%）更明显，且在10岁之前很少见（3%）。骨质流失与糖尿病病程、代谢控制程度或糖尿病并发症之间无明显关联。骨骼成熟延迟并不能解释皮质变薄，骨质减少的糖尿病患者的平均骨龄与非骨质减少的糖尿病患者相似。HLA抗原频率与糖尿病性骨质减少的易感性之间无显著相关性。IDDM患者出现了与慢性糖尿病大鼠先前研究结果相当的代谢改变。记录的数据与以下结论一致：IDDM导致肠道对钙的过度吸收、吸收性高钙尿症、磷尿症、低镁血症、高磷酸酶血症以及循环甲状旁腺激素水平降低。这些矿物质代谢的改变可能与IDDM患者观察到的皮质骨和小梁骨量减少有关。
