骨质疏松合并2型糖尿病老年男性患者血清Sclerostin水平及临床意义

Expression and significance of the serum Sclerostin level in senile male patients with osteoporosis and type 2 diabetes mellitus

目的分析骨质疏松合并2型糖尿病（T2DM）老年男性患者血清骨硬化蛋白（Sclerostin）表达水平及临床意义。方法选择2014年7月。2015年10月在遵义医学院第五附属（珠海）医院确诊骨质疏松症的老年男性患者80例，依据是否合并T2DM分为T2DM组（合并T2DM）与NDM组（非糖尿病），每组各40例。比较两组患者的Sclerostin水平；比较两组患者血钙、血磷、空腹血糖（FPG）、糖化血红蛋白（HbA1c）等生化指标以及k～L4、股骨颈、Ward三角区及大转子区域骨密度数值。应用直线相关分析评估Sclerostin血清水平与骨密度相关性。结果T2DM组血清Sclerostin、FPG及HbA。。显著高于NDM组（均P〈0．01），而两组血钙、血磷比较差异无统计学意义（P〉0．05）。T2DM组股骨颈、Ward三角区及大转子区域骨密度较NDM低（P〈0．05或P〈0．01），而两组L2～L4的骨密度比较差异无统计学意义（P〉O．05）。相关性分析显示，血清Sclerostin与股骨颈及ward三角的骨密度呈负相关（r=-O．650、-0．674，均P〈0．05），而与大转子区域及L2～L4的骨密度无相关性（P〉0．05）。结论骨质疏松合并T2DM老年男性患者血清Sclerostin表达水平较高，且与骨质疏松部位、糖尿病病程及血糖水平有相关性。

Objective To analyze the expression and significance of the serum Sclerostin level in senile male patients with osteoporosis and type 2 diabetes mellitus （T2DM）. Methods Eighty senile male patients with osteoporosis from July 2014 to October 2015 in the Fifth Affiliated Hospital of Zunyi Medical University were collected and divided into two groups, T2DM group （diagnosis to T2DM） and NDM group （diagnosis to non-DM）, each group bad 40 cases. The serum levels of Selerostin were compared between two groups. The biochemical indexes of serum calcium, serum phosphate, FPG, HbAlc and the bone mineral density （BMD） indexes of L2-L4, collum femoris, Ward＇s triangle area, troehiter were compared between two groups. The relationships with the serum levels of Sclerostin and BMD were analyzed by linear correlation. Results The levels of serum Sclerostin, FPG and HbA,c in T2DM group were higher than those of the NDM group （P 〈 0.01）, but the serum calcium and phosphate were no different between groups （P 〉 0.05）. The BMD of eol- lum femoris, Ward＇s triangle area, trochiter in the T2DM group were lower than those of the NDM group （P 〈 0.05 or P 〈 0.01）, but the BMD of L2-L4 in the two groups had no statistically significant difference （P 〉 0.05）. Correlation analy- sis showed the level of serum Sclerostin was negatively correlated with the BMD of collum femoris and Ward＇s triangle area （r = -0.650, -0.674, all P 〈 0.01）, but there were no relationship between the serum Sclerostin level and the BMD of troehiter L2-L4 Conclusion The serum level of Sclerostin raise in senile male patients with osteoporosis and T2DM which is relative to parts of osteoporosis, diabetes course and level of blood sugar.