目的:探讨血清骨钙素水平与绝经后女性2型糖尿病(type2diabetes,T2DM)患者骨密度(boneminaraldensity。BMD)间的关系。方法:本研究为回顾性分析,共纳入505例绝经后女性,其中T2DM住院患者305例,非糖尿病对照者200例.采用双能X线骨密度仪(DXA)检测腰椎(第2至第4腰椎)、股骨颈和全髋的BMD,同时检测血清骨钙素(0steoealcin,OC)水平。结果:与正常对照组相比,T2DM组患者的血清OC水平显著降低(P〈0.05),腰椎、股骨颈、全髋的BMD及体质量指数显著增高fP〈0.01);血清OC水平与女性T2DM患者的腰椎BMD(r=-0.202,P〈0.05)、全髋BMD(r=-0.183。P〈0.05)及体质量指数(r=-0.289,P〈0.01)均呈显著负相关;校正年龄、体质量指数和糖尿病病程后.血清0C水平与腰椎及全髋的BMD间仍存在明显的负相关。结论:血清0C水平与绝经后女性T2DM患者腰椎及全髋的BMD密切相关.随着OC水平的升高.BMD呈下降趋势.提示血清OC水平可作为早期筛查绝经后女性T2DM患者骨质疏松的生化指标.结合血清OC水平和BMD能更好地预测绝经后女性T2DM患者的骨质疏松和骨折的风险。
Objective: To investigate the relationship between serum level of osteocalcin (OC) and bone mineral density (BMD) in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods: A total of 505 postmenopausal women aged (61±7)years were enrolled,including 305 subjects with T2DM and 200 without diabetes served as controls. Serum concentration of OC was determined, and BMDs at lumbar spine (L2-4), femoral neck (FN) and total hip (TH) were measured by dual-energy X-ray absorptiometry (DXA). Results: Serum levels of OC was lower(P〈0.05), whereas BMD (L24, FN,TH) and BMI were higher in T2DM patients than those in subjects without diabetes mellitus (P〈0.01). Linear correla- tion analysis showed that serum OC level was negatively correlated with L24BMD (r=-0.202, P〈0.05), TH BMD(r=-0.183, P〈0.05), and BMI (r=-0.289, P〈0.01) in postmenopausal women with T2DM. L2zBMD and TH BMD had a negative cor- relation with serum OC level even after adjustment for age, BMI and duration of diabetes. Conclusions: Serum OC level is closely related with L2~ and TH BMD in postmenopausal women with T2DM. BMD decreases with the increase of OC level, which demonstrates that serum OC could be used as a screening biochemical indicator for osteoporosis in post- menopausal women with T2DM. A combination of serum OC level and BMD might be a better predictor for osteoporosis and risk of fracture in postmenopausal women with T2DM than when assessed only by BMD.