青年男性不同肥胖表型与骨代谢指标的相关性分析

Correlation Analysis of Different Obesity Phenotype and Bone Metabolism Indexes in Young Males

【目的】 探讨青年男性不同肥胖表型与骨代谢指标的相关性。【方法】 选取青年男性136例,按照不同肥胖表型分为代谢健康体质量指数(BMI)正常组32例(BMI<24 kg/m2且无代谢异常因素,A组)、代谢健康型肥胖组30例(BMI≥28 kg/m^2且无代谢异常因素,B组)、代谢异常型肥胖组74例(BMI≥28 kg/m^2且大于等于1项代谢异常因素,C组)。测量各组血糖[空腹血糖(FPG)、餐后2 h血糖(2hPG)]、血压[收缩压(SBP)、舒张压(DBP)]、血脂[三酰甘油、高密度脂蛋白胆固醇(HDL-C)]及骨代谢标志物[骨钙素(OC)、血总1型胶原羧基端延长肽(P1NP)、1 型胶原交联C-末端肽(CTX)]水平并比较。【结果】 C组的P1NP和OC明显低于A和B组(P<0.001),C组的S-CTX明显高于A组(P<0.001)。肥胖的B组和C组中的相关分析显示:P1NP与FPG呈负相关(r=-0.406,P=0.001),S-CTX与BMI呈正相关(r=0.342,P=0.001),OC与FPG(r=-0.365,P=0.001)、SBP(r=-0.229,P=0.019)、BMI(r=-0.218,P=0.026)、CTX(r=-0.223,P=0.023)呈负相关,OC与P1NP(r=0.245,P=0.012)呈正相关。logistic回归分析显示:C组出现P1NP、OC水平下降分别是A组的4.198倍(95%CI:1.703~10.353,P=0.002)、B组的6.953倍(95%CI:2.513~17.297,P<0.001),C组和B组出现CTX水平升高分别是A组的11.25倍(95%CI:3.854~32.837,P<0.001)和7.062倍(95%CI:2.134~23.367,P=0.001)。【结论】 青年男性不同的肥胖表型其骨代谢指标不同,当代谢异常和肥胖同时存在时,CTX水平明显升高, P1NP、OC水平下降,提示OC指标与代谢指标相关密切。

【Objective】 To investigate the correlation between different obesity phenotypes and bone metabolism in young male.【Methods】 136 young males were selected and divided into three groups according to different obesity phenotypes: normal metabolic health body mass index group(n=32,BMI<24 kg/m^2 and no abnormal metabolic factors, group A), metabolic healthy obesity group (n=30,BMI≥28 kg/m^2 and no abnormal metabolic factors, group B) and abnormal metabolic obesity group (n=74, BMI ≥ 28 kg/m^2 and greater than or equal to 1 item of abnormal metabolism, group C).The blood glucose[fasting blood glucose (FPG), blood glucose (2hPG)], blood pressure[systolic blood pressure (SBP), diastolic blood pressure (DBP)], blood lipid[triglyceride], high-density lipoprotein cholesterol (HDL-C) and bone metabolism marker[bone calcium (OC)],serum total type 1 collagen-base-end extension peptide (P1NP), type 1 collagen-linked C-terminal peptide (CTX) level were measured and compared in each group.【Results】 The P1NP and OC of group C were significantly lower than those of group A and B (P<0.001), and the S-CTX of group A was significantly higher than that of group A (P<0.001).Correlation analysis between obese group B and group C showed that P1NP was negatively correlated with FPG (r=0.406), S-CTX was positively correlated with BMI (r=0.342) and, OC with FPG (r=0.365). There was a negative correlation between SBP (r=0.229,P=0.019), BMI (r=0.218,P=0.026), CTX (r=0.223), CTX (P=0.023). OC was a positive correlated with P1NP (r=0.245,P=0.012).Logistic regression analysis showed that the level of P1NPOC in group C was 4.198 times lower than that in group A (95% CI: 1.703~10.353,P=0.002) and 6.953 times of that in group, B (95% CI:2.513~17.297,P<0.001).The levels of CTX in group C and B were 11.25 times higher than those in group A (95% CI:3.854~32.837,P<0.001) and 7.062 times (95% CI:2.134~23.367,P<0.001).【Conclusion】 Different obesity phenotypes of young males have different bone metabolism indexes. When metabolic abnormality and obesity exist simultaneously, CTX level increases significantly, and P1NPOC level decrease, suggesting that OC index is closely related to metabolic index.