糖尿病患者血清一氧化氮水平对骨代谢影响

Influence of serum nitric oxide level on bone metabolism in diabetic patients

目的探讨糖尿病患者血清一氧化氮水平对成骨细胞、Ⅰ型骨胶原代谢的作用。方法 对确诊1型和2型糖尿病的378例患者测定血清一氧化氮(NO)、一氧化氮合酶(NOS)(硝酸还原酶法)、骨钙素《BGP放免法)、尿脱氧吡啶啉(DPD化学发光法)、尿肌酐(Cr酶法),双能X线测定腰椎正位、前臂、髋部骨密度(BMD),并与同期体检的342例健康人群进行比较。结果 糖尿病患者血清NO、NOS显著高于对照组(P<0.001;P<0.05),BGP显著低于对照组(P<0.001),DPD／Cr则显著高于对照组(P<0.001)。糖尿病组和对照组NO与BGP、DPD及各部位BMD均无显著线性相关(P>0.05)。结论糖尿病患者成骨细胞代谢显著低于健康人而Ⅰ型骨胶原分解代谢则显著高于健康人,血清一氧化氮水平与成骨细胞和Ⅰ型骨胶原代谢无显著相关性。

Objective To study the effect of serum nitric oxide levels on osteoblast and type I ossein metabolism in diabetic patients. Methods Nitric oxide ( NO) , nitric oxide synthase ( NOS) and osteocalcin (BGP) were determined by radioimmunoassny, and urine deoxypyridinoline (DPD) by chemiluminescence in 378 patients with type 1 and type 2 diabetes mellitus. Bone mineral density (BMD) of lumbar vertebrae, hip and forearm were measured by dual energy X-ray absorptiometry(DEXA) .The results were compared with those of 342 healthy subjects at the same time. Results The serum levels of NO and NOS in diabetic patients were significantly higher than those in the controls (P < 0. 001, P < 0. 05). BGP was significantly lower than that in the controls but DPD/Cr markedly higher in diabetic patients( P < 0.001). There were no linear correlation between NO and BGP, DPD/Cr and BMD in the two groups( P > 0. 05). Conclusions The osteoblast metabolism in diabetic patients is significantly lower than that in healthy people, whereas the decomposition of type I is significantly higher. The serum NO level has no correlation with osteoblast and type I ossein metabolism.