Compston J E, Smith E M, Matthews C, Schofield P
Department of Medicine, University of Cambridge Clinical School, Addenbrooke's Hospital, UK.
Clin Endocrinol (Oxf). 1994 Sep;41(3):289-93. doi: 10.1111/j.1365-2265.1994.tb02547.x.
Reduced bone mass has been reported in adult patients with insulin-dependent diabetes mellitus but there are few data on bone density in the axial skeleton or on whole body composition in this group. The aim of this study was to determine whether whole body and regional bone mass are normal in middle-aged women with insulin-dependent diabetes mellitus.
Total and regional bone mass were measured in 24 post-menopausal women aged 43-69 years (mean 56.3) with insulin-dependent diabetes, recruited during routine clinic attendance. Results were compared with those obtained from 24 age and weight-matched community-based post-menopausal women.
Whole body bone mineral content and bone mass in the lumbar spine and femoral neck were measured by dual energy X-ray absorptiometry on a Lunar DPX.
Whole body bone mineral content was significantly lower in the diabetic women than in community-based controls (P = 0.02). There was no significant difference between the two groups in whole body bone density or lumbar spine bone density. Mean bone density in the femur was lower in the patient group at all sites assessed (femoral trochanter P = 0.003, femoral neck, P = 0.057). Values for all regional bone density measurements in the diabetic women were within the Lunar reference range (mean +/- 2 SD) and at all sites the mean value was close to 100% of the sex and age-matched reference value. There was no correlation between duration or control of diabetes and bone mass at any site.
Insulin-dependent diabetes mellitus in middle-aged women is associated with small reductions in total body bone mineral content and in femoral bone density; the clinical significance of these findings in terms of subsequent fracture risk remains to be established. No evidence was found in this study for a reduction in whole body or lumbar spine bone density.
有报道称成年胰岛素依赖型糖尿病患者骨量减少，但关于该群体中轴骨骼骨密度或全身成分的数据较少。本研究的目的是确定中年胰岛素依赖型糖尿病女性的全身和局部骨量是否正常。
对24名年龄在43 - 69岁（平均56.3岁）的绝经后胰岛素依赖型糖尿病女性进行全身和局部骨量测量，这些女性是在常规门诊就诊时招募的。将结果与24名年龄和体重匹配的社区绝经后女性的结果进行比较。
使用Lunar DPX双能X线吸收仪测量全身骨矿物质含量以及腰椎和股骨颈的骨量。
糖尿病女性的全身骨矿物质含量显著低于社区对照女性（P = 0.02）。两组在全身骨密度或腰椎骨密度方面无显著差异。在所有评估部位，患者组股骨的平均骨密度均较低（股骨大转子P = 0.003，股骨颈，P = 0.057）。糖尿病女性所有局部骨密度测量值均在Lunar参考范围内（均值±2标准差），且在所有部位，均值接近性别和年龄匹配参考值的100%。糖尿病病程或控制情况与任何部位的骨量均无相关性。
中年女性胰岛素依赖型糖尿病与全身骨矿物质含量和股骨骨密度的小幅降低有关；这些发现对于后续骨折风险的临床意义仍有待确定。本研究未发现全身或腰椎骨密度降低的证据。
