| Diabetes (Diabetes Mellitus, DM) is the role of genetic and environmental factors caused by a group characterized by chronic high blood glucose metabolism disorders, long-term illness can cause chronic multi-system organ complications, can cause eyes, kidney, neurological, cardiovascular and other organizations dysfunction, or even loss of function. Diabetes not only affects the body's carbohydrate, protein, fat metabolism, but also can affect the calcium and phosphorus metabolism. In recent years, the number of diabetic patients at an alarming rate, in the growing diabetic patients the incidence of osteoporosis is also increased. Whether diabetes can cause osteoporosis is uncertain. Kidney damage is one of the serious complications of diabetes, about 20% of type 2 diabetic patients cumulative incidence to diabetic nephropathy, the clinical features are persistent albuminuria, diabetic nephropathy can cause renal failure, easily lead to calcium, phosphorus and bone metabolism. Parathyroid hormone (parathyroid hormone, PTH) that regulates calcium and phosphorus metabolism in one of the main hormones on bone metabolism is also important. A large number of studies have shown that PTH can promote bone formation and resorption, increase the role of bone turnover. PTH but also by calcium, phosphorus and impact. In diabetic nephropathy may occur early changes in parathyroid hormone levels, along with the progress of diabetic nephropathy, PTH and calcium and phosphorus metabolism increase, can cause bone structure, the abnormal bone turnover, leading to decreased bone density. China's large population, a huge base of patients with diabetes, but people of diabetic kidney damage caused by PTH and bone metabolism less well understood, lack of enough emphasis, almost no effective detection and treatment. Extension with the disease, renal function failure, can significantly reduce bone mineral density, thereby seriously affecting the quality of life of patients with diabetes. Active in the prevention and treatment of diabetic nephropathy in patients with metabolic bone disease, osteoporosis, fractures to avoid not only help to improve the quality of life, but also to save the national health care expenditures. Nowadays the relation between metabolic bone disease and diabetes is becoming a hot spot, however, there is the process of people with diabetic nephropathy due to metabolic bone disease and the relationship between PTH is still unclear, decreased bone mineral density during diabetic patients often asymptomatic in the early. Diabetic kidney disease and therefore changes in parathyroid function and bone metabolism for early diagnosis and early treatment are particularly important. For studies parathyroid hormone in patients with diabetic nephropathy and bone mineral density have important clinical significance.In this study, according to the diagnostic criteria of the diabetes mellitus, we selecte 70 cases of patients from March 2009 to March 2011 in our hospital clinic or ward.And then, according to the diagnostic criteria of the diabetic nephropathy, they are divided into non diabetic nephropathy group, subclinical diabetic nephropathy group, clinical diabetic nephropathy group,final-stage diabetic nephropathy group and set the 28 cases of normal control group. All fasting blood take to detect serum PTH,Ca2+,P3+. We use Lexxos(Holland) dual energy X-ray absorptiometry to measure the bone mineral density of femur neck,great trochanter,Ward's triangle.The measured data applications, applications spss17.0 statistical software for data processing.In the course of counting and analyzing of clinical data,we found that: (1)In final-stage diabetic nephropathy group, Ca2+ levels are significantly lower than the normal control group (p<0.05); in final-stage diabetic nephropathy group, P3+ levels are significantly higher than the normal control group (p< 0.05); in clinical diabetic nephropathy group and final-stage diabetic nephropathy group, serum PTH are significantly higher than the normal control group (p<0.05); in clinical diabetic nephropathy group, serum PTH are significantly higher than the subclinical diabetic nephropathy group (p<0.05); in final-stage diabetic nephropathy group, serum PTH are significantly higher than the clinical diabetic nephropathy group (p<0.05)。(2)In clinical diabetic nephropathy group and final-stage diabetic nephropathy group, BMD levels are significantly lower than the normal control group (p<0.05); in subclinical diabetic nephropathy group, only BMD of femur neck levels are significantly lower than it in the normal control group (p<0.05); in final-stage diabetic nephropathy group, BMD levels are significantly lower than the non-diabetic nephropathy group and subclinical diabetic nephropathy group (p<0.05); in clinical diabetic nephropathy group, the BMD of great trochanter and Ward's triangle are significantly lower than those in the non-diabetic nephropathy group and subclinical diabetic nephropathy group (p<0.05); and the gender,age and BMI of each group is no significant difference (p>0.05) (3)Analyze the final-stage diabetic nephropathy group, we found positive correlation between serum PTH and P3+(r=0.62, p<0.05); negative correlation between serum PTH and Ca2+(r=-0.59, p<0.05); and negative correlation between serum PTH and BMD(r=-0.51, p<0.05).In short, the value of serum PTH and BMD did not change significantly when diabetic patients without renal damage, but when diabetic patients accompanied by renal damage, serum PTH and BMD levels could change. Serum PTH and BMD testing for detection and early intervention in patients with diabetic nephropathy who accompanied by calcium, phosphorus and bone metabolism meaningful, it should be more widely in clinical applications. Combining with the views of experts and scholars from home and abroad for change between Serum PTH and BMD in diabetic nephropathy patients and the research findings, we found that:(1) In clinical diabetic nephropathy group, serum PTH Has begun to rise, when BUN,CREA,Ca2+,P3+ still in the normal range, therefore, serum PTH could be a susceptive index for analysis of renal damage in diabetic nephropathy patients. (2) In clinical diabetic nephropathy group, serum PTH has begun to rise and BMD began to decline when renal function still in the normal, tips should be differentiated from primary hyperparathyroidism, it was important to help us to avoid misdiagnosis in clinical work. (3) With the kidney damage increase, bone mineral density also continued to decline, the amount of bone loss related to the degree of diabetic nephropathy. That diabetic nephropathy deteriorates gradually was an important factor attributes to bone mineral density decline which in diabetic patients, which serum PTH played an important role...
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