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肥胖对2型糖尿病患者骨密度的影响及药物干预疗效观察
作者:单婷  陶小军  马建华 
单位:南京市第一医院 内分泌科, 江苏 南京 210029
关键词:肥胖 骨密度 2型糖尿病 药物治疗 
分类号:R587.1
出版年·卷·期(页码):2017·36·第九期(1324-1327)
摘要:

目的:探究肥胖对2型糖尿病患者骨密度(BMD)的影响,以及二甲双胍对糖尿病性BMD及体重指数(BMI)的影响。方法:对150例2型糖尿病患者根据其BMI分为两组:肥胖组(n=75,BMI>28)和正常组(n=75,23.9>BMI>18.5),两组均给予二甲双胍治疗。结果:两组治疗前的空腹血糖(fFBG)及糖化血红蛋白(Human HbA1C)无统计学差异(P>0.05),与正常组比,肥胖组的BMI较高(P<0.05),治疗后,两组的FBG、HbA1C均明显降低,两组无统计学差异(P>0.05),肥胖组的BMI明显降低(P<0.05),正常组BMI无变化(P>0.05)。治疗前,除手臂BMD,肥胖组的腿部、躯干和全身BMD均明显降低(P<0.05),治疗后,正常组BMD无统计学变化(P>0.05),肥胖组的腿部、躯干和全身BMD均明显增高(P<0.05),两组BMD无统计学变化(P>0.05)。结论:肥胖2型糖尿病可伴不同程度地BMD降低。对肥胖2型糖尿病患者,二甲双胍不仅可以控制血糖水平,而且还可降低BMI和提高BMD,肥胖2型糖尿病患者自二甲双胍的受益明显高于正常组。

Objective: To evaluate the effect of obesity on bone mineral density of patients with type 2 diabetes, and the effect of metformine on diabetic osteoporosis. Methods: A total of 150 patients with type 2 diabetes were assigned to obesity group(n=75, BMI>28) andnormal group (n=75,23.9>BMI>18.5)according to their body mass index(BMI):all used metformin for 1 year. Results: There were no significant differences in fasting blood glucose (FBG) and human haemolysate glycated haemoglobin (HbA1C) between two groups (P>0.05). Compared with the normal group, the BMI of the obesity group was higher (P<0.05). After treatment, the levels of FBG and HbA1C in two groups were significantly lower than those before treatment (P>0.05). The BMI of the obesity group was significantly lower than that before treatment (P<0.05). After treatment, the BMD of the normal group was not statistically changed (P>0.05). The BMD of the legs and torso of the obesity group was significantly higher than that before treatment (P<0.05). Conclusion: Obese type 2 diabetes mellitus may be associated with different degree of BMD reduction. For obese patients with type 2 diabetes, not only dose metformin control blood glucose levels, but also reduces BMI and increases BMD, and obesity patients with type 2 diabetes benefits significantly from metformin than the normal BMI patients with type 2 diabetes.

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