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目的探讨不同分期男性糖尿病肾病(DN)患者血清骨转换指标及骨密度的变化情况。方法 2010年1月-2014年12月,对台州医院610例首诊糖尿病(DM)患者(分为单纯DM组、早期DN组、临床期DN组)及207例健康体检者的骨密度及血清骨转换指标进行统计分析。结果单纯DM组、早期DN组及临床期DN组血清钙(Ca2+)、血清磷(P)、骨钙素N端中分子片段(N-MID)、25羟维生素D(25-OH Vit D)、睾酮(TESTO)水平、腰椎及脊柱骨密度呈逐渐下降趋势,β-胶原降解产物(β-CTX)及甲状旁腺素(PTH)水平呈逐渐上升趋势,差异均有统计学意义(P<0.001)。25-OH Vit D与3组的骨密度具有较高的正相关性,r值分别为0.677、0.728、0.757,P<0.001;N-MID与3组的骨密度具有较高的负相关性,r值分别为-0.415、-0.515、-0.615,P<0.001。结论男性DN患者骨密度随病情发展呈逐渐降低趋势,25-OH Vit D及N-MID可作为DN的重要监测指标。
Objective To investigate the changes of serum bone turnover index and bone mineral density in patients with different stages of male diabetic nephropathy (DN). Methods From January 2010 to December 2014, the bone mineral density (BMD) of 610 first-onset DM patients (divided into simple DM group, early DN group, clinical DN group) and 207 healthy subjects Bone transformation index for statistical analysis. Results Serum calcium (Ca2 +), serum phosphorus (P), N-MID and 25-OH Vit D in DM group, early DN group and DN group were higher than those in control group , Testosterone (TESTO), lumbar and spine BMD, β-CTX and PTH levels gradually increased, the differences were statistically significant (P < 0.001). BMD of 25-OH Vit D had a higher positive correlation with BMD of group 3 (r = 0.677,0.728,0.757, P <0.001). There was a high negative correlation between N-MID and BMD of group 3, r values were -0.415, -0.515, -0.615, P <0.001. Conclusion The BMD of male patients with DN gradually decreases with the progression of the disease. 25-OH Vit D and N-MID can be used as important indicators of DN.