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International journal of endocrinology 1 (73) 2016

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Phosphorus and Calcium Metabolism in Postmenopausal Women with Diabetes Mellitus: Effects of the Type and Duration of the Disease, Time of Menopause and Body Mass

Authors: Kyryliuk M.L., Atanova Ya.O., Tretiak O.E. - Ukrainian Scientific and Practical Centre for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Healthcare of Ukraine, Kyiv, Ukraine

Categories: Endocrinology

Sections: Clinical researches

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Summary

У дослідженні вивчено вплив цукрового діабету (ЦД) на фосфорно-кальцієвий обмін у жінок у постменопаузі залежно від типу та тривалості хвороби, терміну менопаузи, маси тіла та виду гіпоглікемічної терапії. Досліджено стан фосфорно-кальцієвого обміну у 86 жінок: із ЦД 1-го типу — 13 пацієнтів і ЦД 2-го типу — 73 хворих. У всіх пацієнток концентрація кальцію і фосфору в крові була в межах норми. Установлено, що концентрація іонізованого кальцію, загального кальцію та неорганічного фосфору в крові не може слугувати головним критерієм стану мінеральної щільності кісткової тканини в жінок у постменопаузі із ЦД. Препарати сульфонілсечовини та інсуліну в поєднанні з бігуанідами не впливають на стан фосфорно-кальцієвого обміну в жінок у постменопаузі із ЦД 2-го типу.

В исследовании изучено влияние сахарного диабета (СД) на фосфорно-кальциевый обмен у женщин в постменопаузе в зависимости от типа и длительности болезни, срока менопаузы, массы тела и вида гипогликемической терапии. Исследовано состояние фосфорно-кальциевого обмена у 86 женщин: с СД 1-го типа — 13 пациентов и СД 2-го типа — 73 больных. У всех пациенток концентрация кальция и фосфора в крови находилась в пределах нормы. Установлено, что концентрация ионизированного кальция, общего кальция и неорганического фосфора в крови не может служить главным критерием состояния минеральной плотности костной ткани у женщин в постменопаузе с СД. Препараты сульфонилмочевины и инсулина в сочетании с бигуанидами не влияют на состояние фосфорно-кальциевого обмена у женщин в постменопаузе с СД 2-го типа.

The article deals with the impact of diabetes mellitus (DM) on the phosphorus and calcium metabolism in postmenopausal women, depending on the type and duration of the disease, duration of menopause, body mass and type of hypoglycemic therapy. The state of phosphorus and calcium metabolism in 86 women with type 1 DM (13 patients) and type 2 DM (73 patients) was studied. In all patients, the concentration of calcium and phosphorus in the blood was within normal limits. It was found that the concentration of ionized calcium, total calcium and inorganic phosphorus in the blood can not be the main criterion for the state of bone mineral density in postmenopausal women with DM. Sulfonylureas and insulin in combination with biguanides have no effect on the status of phosphorus and calcium metabolism in postmenopausal women with type 2 DM.


Keywords

фосфорно-кальцієвий обмін, цукровий діабет, менопауза, лікування.

фосфорно-кальциевый обмен, сахарный диабет, менопауза, лечение.

phosphorus and calcium metabolism, diabetes mellitus, menopause, treatment.

Background

The problem of osteoporosis is becoming increasingly important. It is connected with the widespread enlargement of  life expectancy. Increasing the number of older people is accompanied by rise frequency of metabolic diseases, including osteoporosis first of all. The presence of type 2 diabetes and menopause significantly worsens the prognosis of patients.

The purpose of the study. the investigation of the impact of diabetes mellitus on phosphorus-calcium metabolism in postmenopausal women, depending on the type and length of diabetes, duration of menopause, weight and type of hypoglycemic therapy.

Material and methods

We examined the state of phosphorus-calcium metabolism in 86 women with diabetes type 1 (13 patients) and diabetes type 2 (73 patients). Exclusion criteria were the presence of severe somatic diseases affecting the phosphorus-calcium metabolism. Patients treated by oral hypoglycemic agents (metformin, sulfonylurea drugs) or combinating insulin therapy (insulin and metformin). Calcium-phosphorus metabolism condition was evaluated by indicators of blood total calcium, ionized calcium, snorganic phosphorus and urinary calcium excretion per day.

Results

The results of the study of diabetes type impact on phosphorus-calcium metabolism revealed normal levels of serum ionized calcium in women in both groups (min 1.0 mM/L; max 1.29 mM/L with type 1 diabetes, min 1.02 mM/L; max 1.36 mM/L with type 2 diabetes). The concentration of inorganic phosphorus in serum of women with type 2 diabetes also did not go beyond the norm (min  0.93 mM/L; max 1.22 mM/L). The results of the study of influence of menopause duration on phosphorous-calcium metabolism indicators in women with type 2 diabetes showed that the differences of total and ionized calcium and inorganic phosphorus between the study groups were not likely. Their ion concentrations in blood serum were within the physiological level. The results of the study of phosphorous-calcium metabolism parameters in women with type 2 diabetes according to depending on the type of hypoglycemic therapy showed that patients in both groups had similar rates of excretion of calcium, serum total and ionized calcium and serum inorganic phosphorus.  

Conclusions

It is shown that the concentration of ionized calcium, general calcium and inorganic phosphorus in the blood can not serve as the main marker of the state of bone mineral density in postmenopausal women with diabetes mellitus. It was found that sulfonylureas drugs and insulin in combination with biguanide not affect on performance of phosphorous-calcium metabolism in postmenopausal women with diabetes mellitus type 2.


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