绝经后女性2型糖尿病患者血清胎球蛋白A水平及与糖脂代谢和骨密度的关系研究

Relationships Between Serum Fetuin-A Levels and Glucose, Lipid Metabolism in Postmenopausal Women with Type 2 Diabetes

目的研究绝经后女性2型糖尿病（T2DM）患者血清胎球蛋白A（Fetuin-A）水平及与骨密度（BMD）和糖脂代谢的关系。方法选择2008年10月至2010年3月在中南大学湘雅二医院内分泌科住院的绝经后T2DM女性患者44例,及年龄、绝经年限、体质量指数相匹配的绝经后健康女性41例。酶联免疫吸附法（ELISA）测定血清Fetuin-A。结果①2型糖尿病组血清Fetuin-A水平较对照组显著降低（359.18±80.06μg/mL,400.98±98.45μg/mL,P〈0.05）,两组第1~4腰椎（PAL1~4）、左侧股骨颈（FN）、股骨干（Inter）、大转子（Troch）及总股骨（Thip）各部位骨密度、HOMA-IR未见明显差异;②2型糖尿病组中,多元线性回归提示TG、BMI与Fetuin-A呈显著正相关（b＇j=0.392,0.308,P〈0.05）,HbA1c与Fetuin-A呈独立负相关关系（b＇j=-0.291,P〈0.05）。结论①绝经后女性T2DM患者血清Fetuin-A水平降低,与高血糖密切相关;②血清Fetuin-A与BMD可能不存在直接关系。

Objective To investigate the relationships between serum Fetuin-A levels with BMD,glucose and lipid metabolism in postmenopausal women with type 2 diabetes mellitus.Methods 49 postmenopausal women with type 2 diabetes were collected from Institute of Metabolism and Endocrinology in the Second Xiangya Hospital of Central South University from Oct 2008 to March 2010,and control group were 44 healthy postmenopausal women matched with age,body mass index and menopausal duration.The serum Fetuin-A were detected by Enzyme-linked immuno-sorbent assay（ELISA） methods.Results ①Compared with the control group,serum levels of Fetuin-A in T2DM group were significantly lower（359.18 ± 80.06 μg/mL,400.98 ± 98.45 μg/mL,P0.05）,but there was no significant difference in HOMA-IR and BMD at PAL1-4,FN,Inter,Troch and Thip.②In T2DM subjects,multiple linear regression analysis showed a positive correlation between Fetuin-A and TG and BMI（b＇j=0.392,0.308,P0.05）,and a negative correlation between FetuinAand HbA1c（b＇j=-0.291,P0.05）.Conclusions ①In postmenopausal women with type 2 diabetes,serum Fetuin-A was decreased,it may be correlated with high plasma glucose.②serum Fetuin-Alevels may not correlate with BMD directly.