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目的 观察老年 2型糖尿病患者尿白蛋白排泄率 (UAE)及血清胰岛素样生长因子 Ⅱ(IGF Ⅱ )、转化生长因子 β(TGF β)、表皮生长因子 (EGF)等细胞因子水平与骨质疏松的相关性。 方法 对照组 14例 ;老年 2型糖尿病患者 51例 ,根据UAE分成正常白蛋白尿组 (UAE <2 0 μg/min)、微量白蛋白尿组 ( 2 0 μg/min≤UAE <2 0 0 μg/min)和大量白蛋白尿组 (UAE≥ 2 0 0 μg/min)。使用双能X线骨密度仪测量前臂松质骨及皮质骨的骨密度 ,测定IGF Ⅱ、TGF β及白介素 6(IL 6)、肿瘤坏死因子(TNF)的血清水平。 结果 3组糖尿病患者松质骨骨密度分别为 ( 3 51 5± 65 3 )g/cm2 、( 3 72 0±66 4)g/cm2 、( 3 71 8± 76 7)g/cm2 ,较对照组 ( 4 76 7± 92 8)g/cm2 降低 (P <0 0 5) ,大量白蛋白尿组皮质骨骨密度 ( 62 1 3± 59 0 )g/cm2 低于对照组 ( 72 5 1± 3 5 9)g/cm2 (P <0 0 5)。糖尿病患者血清IGF Ⅱ、TGF β水平低于对照组 (P <0 0 5) ,IL 6、EGF及TNF与对照组比较 ,差异无显著性。IGF Ⅱ与松质骨T值呈负相关 ,与TGF β正相关。 结论 糖尿病肾病患者易并发骨质疏松 ,可能与IGF Ⅱ、TGF β因子下降有一定相关。
Objective To investigate the relationship between urinary albumin excretion (UAE), serum insulin-like growth factor Ⅱ (IGF Ⅱ), transforming growth factor β (TGF β) and epidermal growth factor (EGF) in elderly patients with type 2 diabetes and osteoporosis Relevance. Methods 14 cases of control group and 51 elderly type 2 diabetic patients were divided into normal albuminuria group (UAE <20 μg / min), microalbuminuria group (20 μg / min≤UAE <200 μg) / min) and a large number of albuminuria group (UAE ≥ 200 μg / min). The BMD of cancellous bone and cortical bone of the forearm was measured by dual energy X-ray absorptiometry. The serum levels of IGF Ⅱ, TGF β, IL 6, and tumor necrosis factor (TNF) were measured. Results The BMD of cancellous bone was (3 51 5 ± 65 3) g / cm2, (3 72 0 ± 66 4) g / cm2 and (3 71 8 ± 76 7) g / cm2 respectively The cortical bone mineral density (62 1 3 ± 59 0) g / cm2 in the albuminuria group was significantly lower than that in the control group (72 5 1 ± 359) g / cm2 (P <0 05). The levels of serum IGF Ⅱ and TGF β in diabetic patients were lower than those in the control group (P <0.05). The levels of IL 6, EGF and TNF in the diabetic group were not significantly different from those in the control group. IGF Ⅱ and cancellous bone T value was negatively correlated with TGF β. Conclusions Patients with diabetic nephropathy are prone to complicated with osteoporosis, which may be related to the decrease of IGF Ⅱ and TGF β.