【摘要】：目的:探討老年2型糖尿病(T2DM)患者血清骨保護素(OPG)和腫瘤壞死因子-α(TNF-α)水平與骨質(zhì)疏松的關(guān)系。方法:將老年2型糖尿病性骨質(zhì)疏松患者45例設(shè)為糖尿病性骨質(zhì)疏松組,老年2型糖尿病骨量正�；颊�45例設(shè)為糖尿病骨量正常組,另將同期老年健康體檢者45例設(shè)為對照組。比較三組一般情況、糖代謝指標、OPG、TNF-α、各部位骨密度(BMD)水平及不同椎體BMD組的OPG、TNF-α水平。結(jié)果:(1)三組性別、年齡、體質(zhì)量(BMI)、收縮壓(SBP)、舒張壓(DBP)、膽固醇總膽固醇(TC)、總甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血鈣(Ca)、磷(P)等指標比較差異無統(tǒng)計學(xué)意義(P0.05);(2)糖尿病性骨質(zhì)疏松組、糖尿病骨量正常組空腹胰島素(FIns)、空腹葡萄糖血糖(FPG)、餐后2小時血糖(2hPG)、糖化血紅蛋白(HbA1c)均明顯高于對照組(P0.05),糖尿病性骨質(zhì)疏松組和糖尿病骨量正常組FIns、FPG、2hPG、HbA1c比較差異無統(tǒng)計學(xué)意義(P0.05);(3)三組間OPG、TNF-α水平比較差異均具統(tǒng)計學(xué)意義(P0.05),糖尿病性骨質(zhì)疏松組最高,對照組最低;(4)對照組各部位BMD水平明顯高于糖尿病性骨質(zhì)疏松組和糖尿病骨量正常組(P0.05),糖尿病性骨質(zhì)疏松組和糖尿病骨量正常組間各部位BMD水平比較差異無統(tǒng)計學(xué)意義(P0.05);(5)不同椎體BMD組間OPG、TNF-α水平比較差異具有統(tǒng)計學(xué)意義(P0.05),即椎體BMD越低,OPG、TNF-α水平越高。結(jié)論:(1)老年2型糖尿病性骨質(zhì)疏松患者OPG、TNF-α水平升高,提示OPG、TNF-α與2型糖尿病性骨質(zhì)疏松的發(fā)生、發(fā)展密切相關(guān)。(2)OPG、TNF-α水平與BMD水平呈負相關(guān)性,表明OPG、TNF-α與骨質(zhì)疏松程度相關(guān),可用于觀察患者病情嚴重程度。
[Abstract]:Objective: to investigate the relationship between serum osteoprotegerin (OPG) and tumor necrosis factor- 偽 (TNF- 偽) levels and osteoporosis in elderly patients with type 2 diabetes mellitus (T2DM). Methods: 45 cases of senile type 2 diabetic osteoporosis were divided into diabetic osteoporosis group, 45 cases of senile type 2 diabetic patients with normal bone mass were divided into normal group of diabetic bone mass, and 45 cases of elderly healthy persons were set as control group. The indexes of glucose metabolism, OPG,TNF- 偽, bone mineral density (BMD) (BMD) level and OPG,TNF- 偽 level in different vertebral body BMD group were compared among the three groups. Results: (1) Sex, age, body weight, (BMI), systolic blood pressure, (SBP), diastolic pressure, (DBP), cholesterol, total cholesterol, (TC), total triglyceride, (TG), high density lipoprotein (HDL-C), There was no significant difference between low density lipoprotein (LDL-C) and calcium (Ca), phosphorus (P) (P0.05). (2) fasting insulin, (FIns), fasting glucose, (FPG), blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) in diabetic osteoporosis group and normal diabetic bone mass group were significantly higher than those in control group (P0.05). There was no significant difference in FIns,FPG,2hPG,HbA1c between diabetic osteoporosis group and normal diabetic bone mass group (P0.05). (3) the levels of OPG,TNF- 偽 were significantly different among the three groups (P0.05), the diabetic osteoporosis group was the highest, the control group was the lowest; (4) the level of BMD in the control group was significantly higher than that in the diabetic osteoporosis group and the normal diabetic group (P0.05). There was no significant difference in BMD levels between diabetic osteoporosis group and normal diabetic bone mass group (P0.05). (5) there was significant difference in OPG,TNF- 偽 level between different BMD groups (P0.05), that is, the lower the BMD, the higher the OPG,TNF- 偽 level. Conclusion: (1) the level of OPG,TNF- 偽 in elderly patients with type 2 diabetic osteoporosis is increased, suggesting that OPG,TNF- 偽 is closely related to the occurrence and development of type 2 diabetic osteoporosis. (2) OPG,. The level of TNF- 偽 was negatively correlated with the level of BMD, indicating that OPG,TNF- 偽 was correlated with the degree of osteoporosis and could be used to observe the severity of the disease.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R580

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