Guarneri M P, Weber G, Gallia P, Chiumello G
Istituto Scientifico Ospedale S. Raffaele, Clinica Pediatrica III, Università degli Studi di Milano, Italy.
J Endocrinol Invest. 1993 Jul-Aug;16(7):505-9. doi: 10.1007/BF03348892.
To investigate bone mineral metabolism in insulin-dependent diabetes mellitus, serum osteocalcin, a marker of bone formation, was measured in 31 diabetic children at onset of disease and 15 days after metabolic improvement by insulin therapy. As a control group for osteocalcin levels we studied 31 healthy sex- and age-matched children. Mean values of serum osteocalcin at onset of diabetes were significantly lower than in control group (p < 0.001), but we did not find any difference after 15 days of insulin therapy. Osteocalcin and parathyroid hormone concentrations were significantly greater after 15 days of insulin treatment than at onset of disease (p < 0.001 and p < 0.01, respectively). The osteocalcin levels were negatively correlated both with fructosamine and with glycosylated hemoglobin (p < 0.01 and p < 0.001, respectively), and positively correlated with the degree of metabolic acidosis at onset (p < 0.05). Therefore we postulate that during glycometabolic imbalance there is a decrease in bone turnover that could be one of the etiological factors of diabetic osteopenia.
为研究胰岛素依赖型糖尿病患者的骨矿物质代谢情况，我们对31例糖尿病患儿在疾病初发时及胰岛素治疗代谢改善15天后测定了血清骨钙素（一种骨形成标志物）。作为骨钙素水平的对照组，我们研究了31例年龄和性别匹配的健康儿童。糖尿病初发时血清骨钙素的平均值显著低于对照组（p < 0.001），但胰岛素治疗15天后我们未发现任何差异。胰岛素治疗15天后骨钙素和甲状旁腺激素浓度显著高于疾病初发时（分别为p < 0.001和p < 0.01）。骨钙素水平与果糖胺和糖化血红蛋白均呈负相关（分别为p < 0.01和p < 0.001），且与初发时的代谢性酸中毒程度呈正相关（p < 0.05）。因此我们推测，在糖代谢失衡期间骨转换降低，这可能是糖尿病性骨质减少的病因之一。
