Tein M S, Breen S A, Loveday B E, Devlin H, Balment R J, Boyd R D, Sibley C P, Garland H O
School of Biological Sciences, University of Manchester, UK.
Exp Physiol. 1998 Mar;83(2):165-74. doi: 10.1113/expphysiol.1998.sp004099.
A disturbed calcium homeostasis characterizes diabetic pregnancy. This study documents changes in bone mineral composition in diabetic pregnant rats and examines the effect of insulin replacement. Control pregnant (CP), diabetic pregnant (DP) and insulin-treated DP (DPi) rats were assessed for femoral calcium and magnesium content, bone mineral density (BMD) and the ratio of hypertrophic to maturing and proliferative cells in the femoral growth plate. DP rats showed a significantly (P < 0.01) lower body weight, femoral weight and length than CP rats. Femoral calcium and magnesium content was also significantly (P < 0.05) lower in DP rats, as was ash weight. When calcium and magnesium were normalized for ash weight no significant differences were apparent. A significantly (P < 0.05) lower total BMD at the distal femur was seen in DP rats. This comprised a significantly (P < 0.01) lower trabecular BMD with no significant change in cortical BMD. A significantly (P < 0.05) higher ratio of hypertrophic to maturing and proliferative cells of the femoral growth plate was evident in DP animals. DPi rats showed normal blood glucose concentrations and femoral growth plate histology. DPi rats also showed normal femoral weight and length but only partially restored femoral ash weight and mineral content. Insulin failed to normalize total or trabecular BMD. Diabetes mellitus clearly has a marked effect on bone growth and mineral content in pregnancy which may be relevant to overall calcium homeostasis. The lower bone growth, bone calcium content and trabecular BMD may be unfortunate consequences of the marked hypercalciuria reported elsewhere in diabetes and may serve to maintain normocalcaemia in the disease.
钙稳态紊乱是糖尿病妊娠的特征。本研究记录了糖尿病妊娠大鼠骨矿物质组成的变化，并研究了胰岛素替代治疗的效果。对对照组妊娠（CP）大鼠、糖尿病妊娠（DP）大鼠和胰岛素治疗的DP（DPi）大鼠的股骨钙和镁含量、骨矿物质密度（BMD）以及股骨生长板中肥大细胞与成熟细胞和增殖细胞的比例进行了评估。DP大鼠的体重、股骨重量和长度显著低于CP大鼠（P<0.01）。DP大鼠的股骨钙和镁含量以及骨灰重量也显著降低（P<0.05）。当将钙和镁按骨灰重量进行归一化处理时，未发现明显差异。DP大鼠股骨远端的总BMD显著降低（P<0.05）。这包括小梁BMD显著降低（P<0.01），而皮质BMD无显著变化。DP动物股骨生长板中肥大细胞与成熟细胞和增殖细胞的比例显著升高（P<0.05）。DPi大鼠血糖浓度和股骨生长板组织学正常。DPi大鼠的股骨重量和长度也正常，但仅部分恢复了股骨骨灰重量和矿物质含量。胰岛素未能使总BMD或小梁BMD恢复正常。糖尿病显然对妊娠期间的骨骼生长和矿物质含量有显著影响，这可能与整体钙稳态有关。骨骼生长降低、骨钙含量降低和小梁BMD降低可能是糖尿病其他部位报道的明显高钙尿症的不良后果，可能有助于维持该疾病的血钙正常。
