内源性可溶性糖化终末产物受体和内源性分泌型糖化终末产物受体水平对糖尿病性骨质疏松症的诊断价值

Diagnostic value of endogenous soluble receptor for advanced glycation end products and endogenous secretory receptor for advanced glycation end products on osteoporosis in patients with type 2 diabetes

目的探讨内源性可溶性糖化终末产物受体(sRAGE)和内源性分泌型糖化终末产物受体(esRAGE)对糖尿病性骨质疏松症的诊断价值。方法 59例≥50岁髋部骨折住院患者分为非糖尿病组(Ⅰ组,20例)、糖尿病非骨质疏松症组(Ⅱ组,21例)及糖尿病合并骨质疏松症组(Ⅲ组,18例),用双能X线骨密度仪检测骨密度(BMD),酶联免疫吸附测定法检测血浆sRAGE、esRAGE水平,并检测空腹血糖(FBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、肌酐(Cr)、碱性磷酸酶(AKP)、钙(Ca)等生物化学指标及体质量指数(BMI)。结果 3组患者的BMI、Cr、TG、TC、AKP水平差异均无统计学意义(P>0.05),Ⅰ组和Ⅱ组患者血浆Ca水平比较差异无统计学意义(P>0.05),但与Ⅲ组Ca水平比较差异均有统计学意义(P<0.01);3组间血浆FBG、HbA1c、BMD、sRAGE、esRAGE水平比较差异均有统计学意义(P<0.01);sRAGE、esRAGE水平与FBG、HbA1c呈负相关(P<0.01),与BMD呈正相关(P<0.01)。结论血浆sRAGE、esRAGE可能成为糖尿病性骨质疏松症的诊断指标。

Objective To investigate the diagnostic value of endogenous soluble receptor for advanced glycation end products（ sRAGE） and endogenous secretory receptor for advanced glycation end products（ esRAGE） on osteoporosis in patients with type 2 diabetes（ DM）. Methods A total of 59 patients with fracture of hip,whose age were ≥50 years old,were categorized as group Ⅰ（ 20 non DM subjects）,group Ⅱ（ 21 DM without osteoporosis subjects）,and group Ⅲ（ 18 DM with osteoporosis subjects）. Bone mineral density（ BMD） was detected by dual-energy X-ray; plasma levels of sRAGE,esRAGE were determined by enzyme linked immunoabsorbent assay and other related indexes including fasting blood glucose（ FBG）,glycosylated hemoglobin（ HbA1c）,triacylglycerol（ TG）,total cholesterol（ TC）,creatinine（ Cr）,alkaline phosphatase（ AKP）,calcium（ Ca） and body mass index（ BMI） in the patients were detected. Results The differences of related indexes including BMI,Cr,TG, TC and AKP were not significant among the three group（ P 0. 05）,while the differences of FBG,HbA1c,Ca,BMD,sRAGE and esRAGE were statistically significant（ P 0. 01）. There was no significant difference in the Ca level in plasma between groupⅠand group Ⅱ,while there was significant difference between group Ⅰ and group Ⅲ; and there was significant difference between group Ⅱ and group Ⅲ. With the severity of diabetes,the levels of FBG and HbA1c were gradually increased, while the levels of sRAGE,esRAGE and BMD were gradually reduced. The levels of sRAGE and esRAGE were negatively correlated with that of FBG and HbA1c,and positively correlated with BMD. Conclusion sRAGE and esRAGE may be new biochemical markers indicating diabetic osteoporosis in the patients with diabetes mellitus.