Vincenti F, Hattner R, Amend W J, Feduska N J, Duca R M, Salvatierra O
JAMA. 1981 Mar 6;245(9):930-3.
Biochemical and bone scintigraphic studies were performed in nondiabetic and diabetic patients receiving hemodialysis at the time of kidney transplantation to assess the degree of secondary hyperparathyroidism. Despite lower serum calcium concentrations, diabetic patients had significantly lower parathyroid hormone (PTH) levels than nondiabetic patients. In addition, diabetic patients had lower graded total-skeletal scintigraphic scores than nondiabetic patients. The PTH levels showed positive correlations with bone scan scores and with alkaline phosphatase in nondiabetic patients but not in diabetic patients. Avascular necrosis occurred in 17% of nondiabetic patients and in only 2% of diabetic patients. Patients with avascular necrosis had significantly higher PTH levels than patients without avascular necrosis. Diabetes mellitus seems to confer a protective effect from the skeletal manifestations of secondary hyperparathyroidism, including avascular necrosis.
对接受肾移植时进行血液透析的非糖尿病患者和糖尿病患者进行了生化和骨闪烁扫描研究，以评估继发性甲状旁腺功能亢进的程度。尽管糖尿病患者血清钙浓度较低，但其甲状旁腺激素（PTH）水平显著低于非糖尿病患者。此外，糖尿病患者的全骨骼闪烁扫描评分等级低于非糖尿病患者。在非糖尿病患者中，PTH水平与骨扫描评分及碱性磷酸酶呈正相关，而在糖尿病患者中则无此相关性。17%的非糖尿病患者发生了无血管性坏死，而糖尿病患者中仅为2%。发生无血管性坏死的患者的PTH水平显著高于未发生无血管性坏死的患者。糖尿病似乎对继发性甲状旁腺功能亢进的骨骼表现（包括无血管性坏死）具有保护作用。
