血清肿瘤标志物在2型糖尿病合并骨量异常患者中意义的研究

The significance of serum tumor makers in type 2 diabetic patients with abnormal bone mass

目的探讨2型糖尿病(type 2 diabetes,T2DM)患者血清中肿瘤标志物与骨密度(bone mineral density,BMD)的关系。方法随机纳入2014年2月至2015年12月就诊于石河子大学医学院第一附属医院内分泌科的T2DM患者240例,根据双能X线骨密度检查结果将研究对象分为T2DM并骨量正常组,T2DM并骨量减低组,T2DM并骨质疏松组,分别比较不同组肿瘤标志物及分析相关因素与骨量的关系。结果(1)与骨量正常组相比,骨量减少组的FPG升高(P<0.05),与骨量正常组相比,骨质疏松组中的FPG升高(P<0.01),与骨量正常组相比,骨质疏松组中的HbAlc升高(P<0.05),与骨量正常组相比,骨量减少组和骨质疏松组中的FINS、HOMA-IR、HOMA-IS降低(P<0.01)。(2)与骨量正常组相比,骨质疏松组CA199升高(P<0.01)。(3)BMD(股骨颈)与血清CA199呈负相关(r=-0.192,P<0.01)。(4)以CA199为因变量,年龄、体重、病程、BMI、FPG、HbAlc、FINS、HOMA-IR、HOMA-IS、BMD(股骨颈)为自变量做回归分析,BMD(股骨颈)(P=0.021,t=-2.328)进入回归方程,Y=34.674-22.65X。结论血清CA199在2型糖尿病合并骨质疏松组患者中升高,且在2型糖尿病患者中BMD越低,CA199水平越高。

Objective To investigate the relationship between serum tumor markers and bone mineral density （BMD） in patients with type 2 diabetes mellitus （T2DM）. Methods Study participants were T2DM patients who were recruited from the Department of Endocrinology of the First Affiliated Hospital of Shihezi University from February 2014 to December 2015. According to the results of dual energy X-ray absorptiomentry BMD examination, the subjects were divided into T2DM and normal bone mass group, T2DM and Osteopenia group, T2DM and osteoporosis group, respectively, to compare tumor markers between the groups of and analyze the relationship between relevant factors and bone mass. Results 1.Compared with the normal bone mass group, the osteopenia group had higher levels of fasting plasma glucose （P 〈 0.05）. Compared with the normal bone mass group, the osteoporosis group had higher levels of fasting plasma glucose （P 〈0.01）. Compared with the normal bone mass group, the osteoporosis group had higher levels of HbAlc （P 〈0.05）. Compared with normal bone mass group, fasting insulin, insulin resistance and insulin secretion in the osteopenia group and the osteoporosis group were lower （P 〈0.01）. 2. Compared with the normal bone mass group, the osteoporosis group had higher CA199 （P 〈0.01）. 3. There was a negative correlation between femoral neck BMD and serum CA199 （r=–0.192, P 〈0.01）. 4. With CA199 as the dependent variable and age, weight, duration of diabetes, BMI, fasting plasma glucose, HbA1c, insulin resistance, insulin secretion and femoral neck BMD as independent variables for multiple linear regression analysis, femoral neck BMD （P =0.021, t=–2.328） entered into the regression equation,Y=34.674–22.65X. Conclusion Serum CA199 increased in patients with type 2 diabetes mellitus and osteoporosis. In patients with type 2 diabetes, the lower bone mineral density, the higher the level of CA199.