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目的分析绝经后2型糖尿病合并抑郁患者骨代谢生化指标与骨密度水平变化。方法选择2013年10月-2014年12月就诊于保定市第一中心医院临床心理科门诊就诊的绝经后女性及内分泌科住院的2型糖尿病患者作为研究对象,依据汉密尔顿抑郁调查量表测定抑郁分值,将所有受试对象分为单纯绝经后组(A组)、绝经后合并抑郁组(B组)、单纯2型糖尿病组(C组)和2型糖尿病合并抑郁组(D组),记录各组年龄、BMI、绝经年限、糖尿病病程,测定FBG、PBG、Hb A1C(%)、血脂、骨代谢生化指标及多部位骨密度,计算各组骨质疏松发生率。结果各组间年龄、BMI、绝经年限无明显差异(P>0.05),C组和D组FBG、PBG、Hb A1c和TC水平无明显差异(P>0.05);C组和D组TG水平明显高于A组和B组(P<0.05);B组和D组OC和β-CTX水平明显高于A组和C组(P<0.05),且C组较A组OC和β-CTX水平明显升高(P<0.05);B组、C组和D组25(OH)D3水平明显低于A组,以D组水平最低(P<0.05);B组和D组股骨颈、大转子BMD较A组和C组明显降低(P<0.05),B组(33.33%)和D组(46.00%)骨质疏松发生率明显高于A组(18.00%)和C组(P<0.05)。结论绝经后2型糖尿病合并抑郁患者其骨代谢呈高转换型,且易发生骨质疏松。
Objective To analyze the changes of biochemical markers of bone metabolism and bone mineral density in postmenopausal type 2 diabetic patients with depression. Methods From October 2013 to December 2014, patients with type 2 diabetes who were admitted to clinical psychology outpatient clinic of the First Central Hospital of Baoding and type 2 diabetic patients who were admitted to Department of Endocrinology were enrolled in this study. Depression scores were determined according to the Hamilton Depression Rating Scale All the subjects were divided into simple postmenopausal group (A group), postmenopausal combined depression group (B group), simple type 2 diabetic group (C group) and type 2 diabetic patients with depression group (D group) The age, BMI, duration of menopause, duration of diabetes, FBG, PBG, Hb A1C (%), blood lipid, biochemical markers of bone metabolism and multi-site bone mineral density were calculated. The incidence of osteoporosis was calculated. Results There were no significant differences in age, BMI and menopause between groups (P> 0.05). There was no significant difference in FBG, PBG, Hb A1c and TC between groups C and D (P> 0.05) (P <0.05). The levels of OC and β-CTX in group B and group D were significantly higher than those in group A and C (P <0.05), and the levels of OC and β-CTX in group C were significantly higher than those in group A (P <0.05). The levels of 25 (OH) D3 in group B, C and D were significantly lower than those in group A, and the lowest in group D (P <0.05) The incidence of osteoporosis in group B (33.33%) and group D (46.00%) was significantly higher than that in group A (18.00%) and group C (P <0.05) . Conclusions Postmenopausal patients with type 2 diabetes mellitus and depression have high conversion type and prone to osteoporosis.