Selby P L, Shearing P A, Marshall S M
Department of Medicine, University of Newcastle upon Tyne, UK.
Diabet Med. 1995 Mar;12(3):240-3. doi: 10.1111/j.1464-5491.1995.tb00465.x.
Increased fracture frequency and low bone mass have each been reported in patients with diabetes. To see if these were related to increased bone resorption we have measured the urinary excretion of hydroxyproline in 73 patients with Type 1 (insulin-dependent) diabetes, 67 patients with Type 2 (non-insulin-dependent) diabetes, and 75 control subjects. Hydroxyproline excretion was increased in both types of diabetes: Type 1: 21 (10-36) (median (IQR) mumol mmol creatinine-1; Type 2: 25 (13-43) mumol mmol creatinine-1; control: 10 (6-22) mumol mmol creatinine-1 (p < 0.0001 and < 0.0002, respectively). Hydroxyproline excretion was not related to age, duration of diabetes or blood glucose control. Neither was it different in patients with or without retinopathy, neuropathy and macrovascular disease. However it was higher in patients with microalbuminuria at 35 (20-53) mumol mmol creatinine-1 than in those with normal protein excretion (25(13-37) mumol mmol creatinine-1 p = 0.03) or those with established proteinuria (18(8-26) mumol mmol creatinine-1 p = 0.001). We conclude that there is evidence of increased bone resorption in diabetes and that this is related to alterations in renal function.
糖尿病患者中骨折频率增加和骨量低的情况均有报道。为了探究这些是否与骨吸收增加有关，我们测量了73例1型（胰岛素依赖型）糖尿病患者、67例2型（非胰岛素依赖型）糖尿病患者以及75名对照者的尿羟脯氨酸排泄量。两种类型糖尿病患者的羟脯氨酸排泄量均增加：1型：21（10 - 36）（中位数（四分位间距）μmol mmol肌酐⁻¹）；2型：25（13 - 43）μmol mmol肌酐⁻¹；对照者：10（6 - 22）μmol mmol肌酐⁻¹（分别为p < 0.0001和< 0.0002）。羟脯氨酸排泄量与年龄、糖尿病病程或血糖控制无关。在有无视网膜病变、神经病变和大血管疾病的患者中也无差异。然而，微量白蛋白尿患者的羟脯氨酸排泄量更高，为35（20 - 53）μmol mmol肌酐⁻¹，高于正常蛋白尿排泄患者（25（13 - 37）μmol mmol肌酐⁻¹，p = 0.03）或已确诊蛋白尿患者（18（8 - 26）μmol mmol肌酐⁻¹，p = 0.001）。我们得出结论，有证据表明糖尿病患者骨吸收增加，且这与肾功能改变有关。
