骨钙素在2型糖尿病合并骨质疏松中意义的研究

The significance of osteocalcin in type 2 diabetic patients with osteoporosis

目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨钙素(osteocalcin,OC)水平与骨密度(bone mineral density,BMD)的关系,进一步探讨OC在2型糖尿病合并骨质疏松(type 2 diabetes with osteoporosis,DOP)中的意义。方法收集我院门诊及病房的T2DM患者213例,测量记录性别、年龄、身高、体重、糖尿病病程,检测空腹血糖(FPG)、血钙(Ca)、磷(P)、血清胆固醇(TC)、甘油三酯(TG)、碱性磷酸酶(ALP)和糖化血红蛋白(Hb A1c),酶联免疫法(ELISA)测定OC,计算体重指数(body mass index,BMI)。结果 (1)骨量减少组(17.65±6.32 ng/mL、9.41±1.77%)与OP组(17.96±7.43 ng/mL、9.65±2.01%)中OC、Hb A1c水平高于正常组(15.71±5.24 ng/mL、8.76±1.89%)(P<0.05)。(2)OP组(66.22±11.03 kg、24.02±3.43 kg/m^2)体重、BMI均低于正常组(73.07±10.40 kg、26.05±3.24 kg/m^2),而OP组ALP(83.35±25.41 U/L)高于正常组(68.34±23.96 U/L)(P<0.01)。(3)相关分析显示:OC与ALP呈正相关(r=0.310,P<0.01);与体重、FPG、股骨颈BMD、L1234BMD呈负相关(r=-0.153、-0.144、-0.164、-0.208,P<0.05)。结论 2型糖尿病患者骨量减少及骨质疏松组中OC表达增高,OC与BMD水平呈负相关,OC有望作为2型糖尿病患者骨质疏松发生发展的参考指标。

Objective To study the relationship between osteocalcin（OC） concentrations and bone mineral density（BMD） in patients with type 2 diabetes mellitus（T2DM）,and to discuss the significance of OC in type 2 diabetic patients with osteoporosis（DOP）. Methods Two hundred and thirteen patients with type 2 diabetes were selected from outpatient clinics and wards in our hospital. Data on gender,age,height,weight and diabetes disease history were collected. The levels of fasting plasma glucose（FPG）,calcium（Ca）,phosphorus（P）,serum total cholesterol（TC）,triglyceride（TG）,alkaline phosphatase（ALP）,hemoglobin A1c（HbA1c） were detected. Osteocalcin was measured using enzyme linked immunosorbent assay（ELISA）. Body mass index（BMI） was calculated. Results 1. The levels of OC and HbA1c in the low bone density group（17. 65 ± 6. 32 ng/mL;9. 41 ± 1. 77%） and osteoporosis（OP） group（17. 96 ± 7. 43 ng/mL; 9. 65 ± 2. 01%） were significantly higher than those of the normal BMD group（15. 71 ± 5. 24 ng/mL; 8. 76 ± 1. 89 %）（P 〈 0. 05）. 2. Compared with the normal BMD group（73. 07 ±10. 40 kg; 26. 05 ± 3. 24 kg/m^2）,body weight and BMI were significantly lower in the OP group（66. 22 ± 11. 03 kg; 24. 02 ± 3. 43kg/m^2）,while the levels of ALP in the OP group（83. 35 ± 25. 41 U/L） were significantly higher than that of the normal BMD group（68. 34 ± 23. 96 U/L）（P 〈 0. 01）. 3. Correlation analysis showed that the expression of OC positively correlated with ALP（r = 0. 310,P 〈 0. 01）,but negative correlated with weight,FPG,femoral neck BMD,L1-4 BMD（r =-0. 153,-0. 144,-0. 164,-0. 208,P 〈 0. 05）. Conclusion The expression of OC increased in the low bone density group and OP group in T2DM patients,and OC negative correlated with BMD. Therefore OC may serve as a reference index for the occurrence and development of osteoporosis in patients with type 2 diabetes.