porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2013114-17porozendo-8843Research ArticleСтатьиArticlesВЗАИМОСВЯЗЬ ДИСТАЛЬНОЙ ДИАБЕТИЧЕСКОЙ ПОЛИНЕЙРОПАТИИ С ПОКАЗАТЕЛЯМИ МИНЕРАЛЬНОЙ ПЛОТНОСТИ КОСТЕЙ СТОП У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМTHE RELATIONSHIP OF THE DISTAL DIABETIC POLYNEUROPATHY WITH PARAMETERS OF FOOT BONE MINERAL DENSITY IN PATIENTS WITH DIABETES MELLITUSМолитвослововаН АMolitvoslovovaN A

аспирант отделения диабетической стопы

natelya@mail.ruЧерноваТ ОZernovaT O

ведущий научный сотрудник отделения рентгенодиагностики и рентгеновской компьютерной томографии, к.м.н.

-ЯрославцеваМ ВYaroslavtsevaM V

старший научный сотрудник отделения диабетической стопы, к.м.н.

-ГалстянГ РGalstyanG R

зав. отделением диабетической стопы, д.м.н., профессор

-ФГБУ «Эндокринологический научный центр» Минздрава России201315122013161№1 (2013)1417Copyright © Молитвословова Н.А., Чернова Т.О., Ярославцева М.В., Галстян Г.Р., 20132013Молитвословова Н.А., Чернова Т.О., Ярославцева М.В., Галстян Г.Р.Molitvoslovova N.A., Zernova T.O., Yaroslavtseva M.V., Galstyan G.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/8843

Цель исследования: оценить показатели МПК костей стоп у пациентов с сахарным диабетом при различной степени выраженности дистальной диабетической полинейропатии. В исследование включен 61 пациент с СД (СД1-27, СД2-34), из них 37 имели диабетическую остеоартропатию (ДОАП) 1 группа, 13 (2 группа) пациентов с тяжелой полинейропатией, 3 группа 11 больных с умеренной полинейропатией и группа контроля 15 человек. Было выполнено денситометрическое исследование (аппарат Lunar Prodigy, General Electric, США) с определением МПК в поясничном отделе позвоночника, проксимальном отделе бедра и лучевой кости, а также расчет показателей МПК в стопах в программе «Total Body» с выбором функции анализ отдельных регионов интереса. Достоверных отличий в показателях МПК стоп между группами больных выявлено не было, а в группе контроля был достоверно выше по сравнению с 1 (р=0,031) и 3 группами (р=0,027). Была выявлена сильная прямая корреляционная связь показателя МПК стоп с МПК других отделов, положительная корреляция с ИМТ (r=0,4, р=0,000), отрицательная с уровнем НbА1с (r=-0,2, р=0,045) и длительностью СД (r=-0,3, р=0,006). Полученные результаты свидетельствуют о том, что дистальная диабетическая нейропатия не является фактором, определяющим снижение показателей МПК стоп.

The aim of the study was to evaluate foot bone mineral density (BMD) in diabetes mellitus (DM) complicated with distal neuropathy (DN). Materials and methods. 61 patients with DM (DM1-27, DM2-34) were included. 37patients had Charcot osteoarthropathy (the 1st group), the 2nd group (13 patients) with severe DN, the 3rd group (11 patients) with mild DN, and control group consisted of 15 healthy people. All patients underwent dual energy X-ray absorptiometry (DXA) Lunar Prodigy scan. BMD was measured in lumbar spine, hip and radius. Foot BMD was measured using the «Total Body» region’s analysis. Results. There was a significant difference in foot BMD between controls and the 1st (р=0,031) and the 3rd (р=0,027) groups with no significant difference between the groups of patients. Foot BMD significantly correlated with spine, hip and radiusBMD (г=0,5-0,63, р<0,00001), BMI (r=0,4, р=0,000). Negative correlation was found between foot BMD and diabetes duration (r=-0,3, p<0,005) and HbA1c (r=-0,2, р=0,045). No correlation was found between DN and foot BMD. Conclusion. No association between severity of DN and foot BMD was found.

дистальная диабетическая полинейропатияостеопорозсахарный диабетdistal neuropathydiabetes mellitusosteoporosis

ВЗАИМОСВЯЗЬ ДИСТАЛЬНОЙ ДИАБЕТИЧЕСКОЙ ПОЛИНЕЙРОПАТИИ С ПОКАЗАТЕЛЯМИ МИНЕРАЛЬНОЙ ПЛОТНОСТИ КОСТЕЙ СТОП У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ

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The authors declare that there are no conflicts of interest present.