男性2型糖尿病患者1型前胶原氨基端前肽与糖化血红蛋白水平的相关性研究

The investigation of the relationship between propeptide of typeⅠ procollagen and hemoglobin A_(1C) in males with type 2 diabetes mellitus

目的探讨男性2型糖尿病(T2DM)患者的糖化血红蛋白水平与骨转换指标1型前胶原氨基端前肽(PINP)的关系,进一步明确不同血糖水平对PINP的影响。方法选取2014年3月至2016年10月合肥市第一人民医院内分泌科收治的94例住院男性T2DM患者为研究对象。测定患者的糖化血红蛋白(Hb A1C)、血脂、胱抑素C(Cys-C)、PINP、血清1型胶原交联C-末端肽(CTX)等指标。按照Hb A1C水平分为A组(Hb A1C<9.0%)44例和B组(Hb A1C≥9.0%)50例。用SPSS19.0软件进行t检验,指标间的相关性分析采用Pearson相关分析,以PINP和CTX为因变量,进行多元逐步回归分析。结果 A组PINP水平为(14.81±6.67)nmol/L,B组PINP水平为(11.82±6.74)nmol/L,A组高于B组,差异有统计学意义(P<0.05)。两组患者CTX水平分别为(4.34±2.64)和(4.27±2.36)nmol/L,差异无统计学意义(P>0.05)。Pearson相关分析结果显示,PINP与Hb A1C呈负相关(r=-0.248,P<0.05),与Cys-C呈正相关(r=0.269,P<0.01);CTX与各项指标的相关性均无统计学意义(P>0.05)。多元线性回归分析结果显示,男性T2DM患者中,对PINP有影响的指标是Hb A1C(β’=-0.306,P<0.01),Hb A1C水平越高,PINP水平越低;未发现对CTX水平产生影响的指标(P>0.05)。结论男性T2DM患者血糖控制水平越差,骨形成指标PINP越低,高血糖可抑制成骨细胞的活动,积极控制血糖可有助于减少骨折的风险。

Objective To explore the relationship between propeptide of type I procollage （PINP） and hemoglobin Mc （HbA1c） in males with type 2 diabetes mellitus （T2DM）, and to investigate the influence of different blood glucose levels on PINP. Methods From March of 2014 to October of 2016, 94 male inpatients with T2DM were selected as the subjects.The levels of HbMc, serum lipid, eystatin C （Cys-C）, PINP and CTX were detected for all subjects. According to the levels of HbA1c, all subjects were divided into A group （HbAlc〈9.0%, 44 cases） and B group （HbAlc≥9.0%, 50 cases）. The data were analyze with t test, the correlation between indexes was analyzed with Pearson correlation, multiple stepwise regression method was used to analyze the influencing factors on PINP, and the used software was SPSS 19.0. Results PINP level （14.81±6.67 nmol/L） of group A was significantly higher than that （ 11.82±6.74 nmol/L） of group B （P〈0.05）. The levels of CTX in two groups were （4.34±2.64） and （4.27±2.36） nmol/L, there was no significant difference （P〉0.05）. Pearson correlation analysis showed that PINP was negatively correlated with HbA,c level （r=-0.248, P〈0.05）, and positively correlated with Cys-C level （r=0.269, P〈0.01 ）. The correlation between CTX and the indexes was not statistically significant （P〉0.05）. Multivariate stepwise regression analysis showed that HbAtc level could significantly influence the PINP in male patients with T2DM （β =-0：306, P〈0.01 ）, the PINP level decreased with HbAlc level. But it was not found that CTX level could significantly influence other indexes （P〉0.05）. Conclusion The male T2DM patients with low controlling blood glucose has low PINP level, high blood glucose can inhibit the activity of osteoblasts, so controlling blood glucose can reduce the risk of fracture.