2型糖尿病患者血清骨保护素水平与氧化应激的关系

Serum bone protection levels and its relationship with oxidative stress in type 2 diabetes patients

目的:探讨2型糖尿病(T2DM)患者血清骨保护素(OPG)与患者氧化应激水平的关系。方法:选取2014年1月至2015年12月在邯郸市中心医院诊治的128例T2DM患者进行研究,根据骨密度(BMD)将其分为骨量正常组45例、骨量减少组42例、骨质疏松组41例,另选取年龄、性别基本匹配的50例健康人群作为对照组,检测各组的血清骨保护素(OPG)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、晚期蛋白质氧化产物(AOPP),并分析相互间关系。结果:骨量正常组、骨量减少组、骨质疏松组的SOD、GSH、GSH-Px测定值显著高于对照组(P<0.05),骨质疏松组的SOD、GSH-Px、CAT显著低于骨量减少组和骨量正常组(P<0.05),骨质疏松组的SOD、GSH显著低于骨量正常组(P<0.05);骨量正常组、骨量减少组、骨质疏松组的MDA、OPG、AOPP测定值显著高于对照组(P<0.05),骨质疏松组的OPG、AOPP显著高于骨量减少组、骨质疏松组(P<0.05);骨质疏松组的MDA显著高于骨量正常组(P<0.05)。多元逐步回归分析法分析结果显示:OPG=-0.481(SOD)-0.322(GSH)+2.755(MDA)-0.319(GSH-Px)+1.672(AOPP);OPG与SOD、GSH、GSH-Px呈负相关关系(P<0.05),与MDA、AOPP呈正相关关系(P<0.05)。结论:T2DM患者OPG水平与氧化应激密切相关,氧化应激可能促进了糖尿病骨质疏松的发生发展。

Objective： To investigate the relationship between serum levels of bone protective factor（ OPG） and oxidative stress in patients with type 2 diabetes mellitus（ T2DM）. Methods： January 2014 to December 2015,128 patients with T2DM in Handan Central Hospital were selected. According to the bone mineral density（ BMD）,they were divided into 45 cases of the normal bone mass group,42 cases of the bone mass reduction group and 41 cases of osteoporosis group,another 50 cases of healthy people were selected as the control group. Serum OPG,SOD,GSH,MDA,CAT,GSH-Px and AOPP wrer detected,and the relationship among the groups was analyzed.Results： SOD,GSH,GSH-Px in the normal bone mass group,osteopenia group and osteoporosis group were significantly higher than those in the control group（ P 0. 05）. SOD,GSH-Px,CAT in the osteoporosis group were significantly lower than those of the osteopenia group and normal bone mass group（ P 0. 05）. SOD and GSH in the osteoporosis group were significantly lower than those in the normal bone mass group（ P 0. 05）. MDA,OPG,AOPP in the normal bone mass group,osteopenia group,osteoporosis group were significantly higher than those in the control group（ P 0. 05）. OPG and AOPP in the osteoporosis group were significantly higher than those of osteopenia group,osteoporosis group（ P 0. 05）. MDA in the osteoporosis group was significantly higher than that of normal bone mass group（ P 0. 05）. Multiple stepwise regression analysis showed that OPG =-0. 481（ SOD）-0. 322（ GSH） ＋ 2. 755（ MDA）-0. 319（ GSH-Px） ＋ 1. 672（ AOPP）; OPG was negatively correlated with SOD,GSH,GSH-Px（ P 0. 05）,and positively correlated with MDA,AOPP（ P 0. 05）.Conclusion： OPG level in patients with T2DM is closely related to oxidative stress,oxidative stress may contribute to the development of diabetic osteoporosis.