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阿塞拜疆糖尿病绝经前和绝经后女性的骨代谢参数

Bone Metabolism Parameters in Azerbaijani Pre and Postmenopausal Women with Diabetes.

作者信息

Safarova Sain Sattar

机构信息

Department of Internal Medicine, Azerbaijan Medical University, Baku, Azerbaijan.

出版信息

Iran J Public Health. 2023 Feb;52(2):334-339. doi: 10.18502/ijph.v52i2.11886.

DOI:10.18502/ijph.v52i2.11886
PMID:37089145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10113590/
Abstract

BACKGROUND

This study aimed to determine the directionality of changes in serum bone remodeling markers and bone mineral density in the pre- and postmenopausal women with diabetes mellitus.

METHODS

This study was carried out during the years 2016-2017 on the basis of Azerbaijan Medical University and included 142 pre- and postmenopausal women with type 1 and 2 diabetes mellitus (DM 1and DM2) were compared with 43 age-matched non-diabetics. The groups evaluated Ca, PTH, CT, 25(OH)D levels, serum bone remodeling markers (ALP, P1NP, b-CTx), lumbar spine, proximal and femoral neck areas using DXA assessment.

RESULTS

The results showed inconsistency observed between bone remodeling processes in women with diabetes. A negative correlation was observed between duration of diabetes and Lumbar T-scores (DM1: r = -0.568, = 0.001; DM2: r = -0.267, = 0.04). Lumbar T-scores was negatively correlated with b-CTx level (DM1: r = -0.452, = 0.002; DM2: r = -0.357, = 0.09). Postmenopausal groups with DM1 and DM2 were slightly higher b-CTx levels than premenopausal.

CONCLUSION

The patients with DM2 compared to DM1 had higher average BMD at all measured areas. Bone fragility is the result not so much of a decrease in BMD, but alterations in bone microstructure, as indicated by the disregulation of bone remodeling markers. This suggests that patients with diabetes are at a higher risk of bone turnover disorders compared to individuals without diabetes, which does not necessarily correlate with differences in BMD.

摘要

背景

本研究旨在确定绝经前后糖尿病女性血清骨重塑标志物和骨矿物质密度变化的方向性。

方法

本研究于2016年至2017年在阿塞拜疆医科大学进行,纳入了142例绝经前后的1型和2型糖尿病女性(DM1和DM2),并与43例年龄匹配的非糖尿病患者进行比较。通过双能X线吸收法(DXA)评估各组的钙、甲状旁腺激素(PTH)、降钙素(CT)、25羟维生素D[25(OH)D]水平、血清骨重塑标志物(碱性磷酸酶[ALP]、I型前胶原氨基端前肽[P1NP]、β-胶原降解产物[b-CTx])、腰椎、近端和股骨颈区域。

结果

结果显示糖尿病女性的骨重塑过程存在不一致性。糖尿病病程与腰椎T值呈负相关(DM1:r = -0.568,P = 0.001;DM2:r = -0.267,P = 0.04)。腰椎T值与b-CTx水平呈负相关(DM1:r = -0.452,P = 0.002;DM2:r = -0.357,P = 0.09)。DM1和DM2的绝经后组b-CTx水平略高于绝经前组。

结论

与DM1相比,DM2患者在所有测量区域的平均骨密度更高。骨脆性与其说是骨密度降低的结果,不如说是骨微结构改变的结果,这表现为骨重塑标志物的失调。这表明与非糖尿病个体相比,糖尿病患者发生骨转换紊乱的风险更高,这不一定与骨密度差异相关。

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Mechanisms involved in altered bone metabolism in diabetes: a narrative review.糖尿病中骨代谢改变的相关机制:一篇叙述性综述
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