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| 用定量超声和双能X线吸收法测定2型糖尿病绝经后妇女骨密度的区别 |
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| Differences between measurements of bone mineral densities by quantitative ultrasound and dual-energy X-ray absorptiometry in type 2 diabetic postmenopausal women |
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| Tao B., Liu J.-M., Zhao H.-Y., Sun L.-H., Wang W.-Q., Li X.-Y., Ning G. 2009/5/29 18:38:57 |
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Journal of Clinical Endocrinology and Metabolism, 2008, Volume 93, Issue 5
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| Context: Quantitative ultrasound (QUS) may be more helpful than dual-energy X-ray absorptiometry (DXA) in detecting bone deficits in patients with type 2 diabetes mellitus (T2DM). Objective: The objective of the study was to compare differences in bone mass measurement by DXA and QUS in T2DM and nondiabetic postmenopausal women. Design, Setting, and Participants: This clinical investigation was a cross-sectional study in 76 patients with T2DM and 86 nondiabetic postmenopausal women. Main Outcome Measures: The primary outcomes were speed of sound (SOS) at the radius, phalanx, and tibia measured by QUS and bone mineral density (BMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) measured by DXA. Results: BMDs in T2DM patients were higher (LS, 1.06 ± 0.12 vs. 0.90 ± 0.23 g/cm2; FN, 0.80 ± 0.13 vs. 0.74 ± 0.12 g/cm2; TH, 0.87 ± 0.14 vs. 0.80 ± 0.13 g/cm2, respectively, P < 0.001), whereas SOSs were lower than those in nondiabetics (radius, 4044 ± 178 vs. 4129 ± 182 m/sec; phalanx, 3902 ± 207 vs. 3999 ± 214 m/sec, respectively, P < 0.001). The positive relationships between SOS and BMD (r = 0.26-0.75, P < 0.05) in nondiabetics were not observed in women with T2DM. T2DM impacted negatively on SOSs (radius, β= -0.223, P <0.01; phalanx, β= -0.219, P <0.01) but positively on BMDs (LS, β = 0.314, P < 0.001; FN, β = 0.173, P < 0.05; TH, β = 0.203, P <0.01). Conclusions: Differences in bone mass as measured by DXA and QUS in postmenopausal T2DM and nondiabetic women do not change in parallel. QUS can provide useful information in the skeletal assessment of patients with T2DM. Copyright © 2008 by The Endocrine Society. |
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| Correspondence Address: Ning, G.; Department of Endocrine and Metabolic Diseases, Shanghai Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, 197 Ruijin Er Road, Shanghai 200025, China; email: guangning@medmail.com.cn |
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 疾病资源中心
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
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