内脂素和脂联素与中青年2型糖尿病患者骨密度及骨代谢关系的研究

Analysis of Relationship between Visfatin,Adiponectin Levels and Bone Mineral Density,Bone Metabolism in Middle-aged People with Type 2 Diabetes Mellitus

目的探讨内脂素、脂联素与中青年2型糖尿病(T2DM)患者骨密度(BMD)及骨代谢的关系。方法收集2010年1月—2012年1月在我院就诊的中青年2型糖尿病患者127例(T2DM组),同期将在我院体检中心及课题组社区进行流行病学调查检查血糖正常的健康者120例(对照组),两组年龄均为20～40岁。比较两组受检者的年龄、腰臀比及体质指数(BMI),采用酶联免疫法(ELISA法)测定血清内脂素、脂联素水平,双能X线骨密度仪测定腰椎(L2～L4)及左股骨颈BMD,ELISA法检测血清骨钙素(BGP)及Ⅰ型胶原胶联蛋白羧基肽(CTX-Ⅰ)。采用SPSS 13.0统计软件进行统计学处理,组间比较采用两独立样本t检验,两因素间的关系采用Pearson相关分析。结果 (1)两组受检者的BMI及腰臀比比较,差异均无统计学意义(P>0.05);而T2DM组血清内脂素水平、腰椎(L2～L4)及左股骨颈BMD高于对照组,而脂联素、BGP、CTX-Ⅰ水平则低于对照组,差异均有统计学意义(P<0.05)。(2)相关分析显示,BMI、腰臀比、内脂素均与腰椎及左股骨颈BMD呈正相关(P<0.05),与BGP、CTX-Ⅰ呈负相关(P<0.05);而脂联素与腰椎及左股骨颈BMD呈负相关(P<0.05),与BGP、CTX-Ⅰ呈正相关(P<0.05)。结论血清内脂素、脂联素水平与中青年T2DM患者骨代谢、腰椎及左股骨颈BMD相关。

Objective To discuss the relationships between visfatin,adiponectin levels and bone mineral density（BMD）,bone metabolism in middle-aged people with type 2 diabetes（T2DM）.Methods 127 middle-aged T2DM patients admitted to our hospital from January 2010 to January 2012 were selected as T2DM group,and meanwhile,120 healthy people were selected as control group,with the age of both groups being 20 to 40.The age,waist to hip ratio（WHR） and BMI were compared between the two groups.ELISA method was used to detect visfatin and adiponectin levels as well as BGP and CTX-Ⅰ and DXA was used to detect lumbar spinal（L2 to L4） and left collum femoris BMD.SPSS 13.0 software was used to make statistical analysis.Group comparison was analyzed by t test and correlation analysis was performed by Pearson analysis.Results（1）The BMI and WHR between the two groups showed no statistically significant differences（P0.05）.The serum visfatin levels,lumbar spinal BMD and collum femoris BMD in the T2DM group were significantly higher than those in the control group,while serum adiponectin,BGP and CTX-Ⅰ levels in the T2DM group were significantly lower than those of the control group（P0.05）.（2）Correlation analysis showed that BMI,WHR and visfatin were positively correlated with lumbar spinal BMD and collum femoris BMD（P0.05）,but were negatively correlated with BGP and CTX-Ⅰ（P0.05）.Serum adiponectin was negatively correlated with lumbar spinal BMD and collum femoris BMD,positively correlated with BGP and CTX-Ⅰ（P0.05）.Conclusion Serum adiponectin and visfatin levels are correlated with bone metabolism,lumbar spinal and collum femoris BMD in middle-aged people with type 2 diabetes.