2型糖尿病骨钙素、25羟维生素D水平与颈动脉内膜中层厚度的相关性研究

The correlation between osteocalcin,25 hydroxy vitamin D and carotid intima-media thickness in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者外周血骨钙素(BGP)、25羟维生素D[25-(OH)-D]水平与颈动脉内膜中层厚度(IMT)的相关性。方法选取甘肃省人民医院内分泌科T2DM患者66例,健康对照组40例,采用电化学发光法测定血清BGP和25-(OH)-D水平,彩色多普勒超声诊断仪测定IMT。应用独立样本t检验、Pearson相关分析、多元线性回归分析及Logistic回归分析等统计学方法对数据进行分析。结果 T2DM组BGP水平较对照组显著降低(P<0.05);25-(OH)-D水平较对照组降低,但差异无统计学意义(P>0.05),IMT较对照组显著增高(P<0.05)。Pearson相关分析表明:IMT与胰岛素抵抗指数(HOMA-IR)呈正相关(r=0.410,P<0.05)、与BGP呈负相关(r=-0.274,P<0.05)。BGP水平与空腹血糖(FBG)、糖化血红蛋白(Hb A1c)和甘油三酯(TG)呈负相关(r=-0.335、-0.256、-0.204均P<0.05)。多元线性逐步回归分析显示:BGP、年龄、FBG是IMT的独立影响因素。Logistic回归分析显示BGP水平降低是颈动脉斑块形成的危险因素。结论 BGP水平降低是2型糖尿病动脉粥样硬化的危险因素。

Objective To investigate the correlation between osteocalcin （BGP）, 25 hydroxy vitamin D [25-（OH）-D] and carotid intima-media thickness （IMT） in patients with type 2 diabetes mellitus （T2DM）. Methods The serum level of BGP, 25-（OH）-D and the carotid IMT were tested and compared between 66 patients with T2DM and 40 healthy subjects. All the data was analyzed with the t-test, pearson linear analysis, multivariate linear stepwise regression model and logistic regres-sion model. Results The level of BGP reduced markedly in T2DM group than that in control group （P〈0.05）. The level of 25-（OH）-D was lower in T2DM group than control group, but the difference was not statistically significant （P〉0.05）. The lev-el of IMT increased markedly in T2DM group than that in control group （P〈0.05）. Pearson linear analysis showed that IMT was positively correlated with Homa insulin resistant indictor （HOMA-IR） （r=0.410, P〈0.05）, and IMT was negatively correlated with the level of BGP （r=-0.274, P〈0.05）. BGP level was negatively correlated with FBG, HbA1c and TG, r=-0.335,-0.256,-0.204 respectively P〈0.05. Multivariate linear stepwise regression analysis showed that BGP , Age and FBG were the indepen-dent risk factors for IMT in patients with type 2 diabetes mellitus. Logistic regression analysis showed that decreased BGP level was a risk factor of carotid artery plaque formation. Conclusion The decrease of BGP level is a risk factor for the pathogene-sis of atherosclerosis in type 2 diabetes patients.