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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(f FBG)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 investigate the effect of obesity on bone mineral density (BMD) in type 2 diabetic patients and the effect of metformin on diabetic BMD and body mass index (BMI). Methods: 150 type 2 diabetic patients were divided into two groups according to their BMI: obese group (n = 75, BMI> 28) and normal group (n = 75,23.9> BMI> 18.5). Both groups were given metformin. Results: There was no significant difference in fasting blood glucose (F FBG) and HbA1C between the two groups before treatment (P> 0.05). Compared with the normal group, the obese group had higher BMI (P <0.05) The FBG and HbA1C in both groups were significantly lower than those in control group (P> 0.05). The BMI in obese group was significantly lower than that in obese group (P <0.05). Before treatment, BMD of leg, trunk and whole body in obesity group were significantly decreased (P <0.05) except BMD of arm, but there was no significant difference in BMD of normal group (P> 0.05) The BMD of the whole body was significantly increased (P <0.05). There was no statistical difference in the BMD between the two groups (P> 0.05). Conclusion: Obese type 2 diabetes mellitus may be associated with varying degrees of BMD reduction. In obese patients with type 2 diabetes, metformin not only controls blood glucose levels but also lowers BMI and increases BMD. The benefits of metformin in obese type 2 diabetic patients are significantly higher than those in normal subjects.