Leite Duarte M E, da Silva R D
Departamento de Patologia, Universidade Federal Fluminense.
Rev Hosp Clin Fac Med Sao Paulo. 1996 Jan-Feb;51(1):7-11.
The effects of long-term diabetes mellitus on mineral metabolism and bone integrity remain ill defined. Several studies have shown that patients with insulin-dependent diabetes mellitus (IDDM) have reduced bone mass. However, the effect of non-insulin-dependent diabetes mellitus (NIDDM) on bone mass has been controversial. Quantitative histologic assessments were completed in iliac crest bone samples obtained from 26 patients (13 male and 13 female) with non-insulin-dependent diabetes mellitus (NIDDM) and normal renal function (serum creatinine 1.00 +/- 0.04 mg/dl). The mean age was 67.42 +/- 2.74 yrs, range 50-89 yrs. For the control group the bone samples were taken from 20 non-diabetic subjects (11 male and 9 female) with a mean age of 57.95 +/- 3.96 yrs, range 33-91 yrs, n.s, that had suffered sudden or violent death. Significant lower values were present in the diabetic group for bone volume (p < 0.0001), osteoid volume (p < 0.005), osteoid thickness (p < 0.0001), cortical thickness (p < 0.05) and osteoblast surface (p < 0.05). Linear regression analysis revealed significant positive correlations of osteoid volume with osteoid thickness and osteoid surface in both groups. Our results suggest that the mechanism(s) underlying diabetic osteopenia may involve decreased bone turnover as reflected in a paucity of osteoblasts and diminished quantities of osteoid. A proeminent additional feature was a reduction in the cortical thickness.
长期糖尿病对矿物质代谢和骨骼完整性的影响仍不明确。多项研究表明,胰岛素依赖型糖尿病(IDDM)患者的骨量减少。然而,非胰岛素依赖型糖尿病(NIDDM)对骨量的影响一直存在争议。对26例非胰岛素依赖型糖尿病(NIDDM)且肾功能正常(血清肌酐1.00±0.04mg/dl)的患者(13例男性和13例女性)的髂嵴骨样本进行了定量组织学评估。平均年龄为67.42±2.74岁,范围为50 - 89岁。对照组的骨样本取自20例非糖尿病受试者(11例男性和9例女性),平均年龄为57.95±3.96岁,范围为33 - 91岁,这些受试者因突发或暴力死亡。糖尿病组的骨体积(p < 0.0001)、类骨质体积(p < 0.005)、类骨质厚度(p < 0.0001)、皮质厚度(p < 0.05)和成骨细胞表面(p < 0.05)的值显著较低。线性回归分析显示,两组中类骨质体积与类骨质厚度和类骨质表面均呈显著正相关。我们的结果表明,糖尿病性骨质减少的潜在机制可能涉及骨转换减少,这表现为成骨细胞数量减少和类骨质数量减少。一个突出的额外特征是皮质厚度降低。