2型糖尿病患者血清羧化不全骨钙素与糖、脂代谢的相关性

Relationship between serum undercarboxylated osteocalcin and glucose and lipid metabolism in type 2 diabetes

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清羧化不全骨钙素(undercarboxylated osteocalcin,uc OC)水平与糖、脂代谢的关系。方法 123例T2DM患者根据病程分为D1组(<5年组,43例)、D2组(5~15年组,51例)、D3组(>15年组,29例),40名正常体检者作为对照组。比较各组间血清uc OC水平和糖脂代谢指标差异。另外将T2DM患者按uc OC高低分为两组,分析其与糖、脂代谢指标的相关性。结果 (1)T2DM组三酰甘油(triglyceride,TG)显著高于对照组[(2.24±1.64)mmol/L vs.(1.44±0.76)mmol/L],而血清uc OC浓度明显低于对照组[(0.43±0.35)mg/L vs.(1.52±0.88)mg/L];(2)T2DM患者血清uc OC水平与糖化血红蛋白(glycosylated hemoglobin,Hb A1c)、TG呈负相关(P=0.005,P=0.008);Hb A1c水平与血清空腹C肽(fasting c-peptide,FCP)呈负相关(P=0.009),与Ⅰ型胶原羧基端交联肽(β-C-terminal telopeptide of type 1 collagen,CTX)呈正相关(P=0.016)。结论 uc OC可作为一种能量代谢调节激素对糖、脂代谢起正性调控作用,可能在T2DM发病过程中起一定作用。

Objective To explore the relationship between serum undercarboxylated osteocalcin（ uc OC） and glucose and lipid metabolism in type 2 diabetes. Methods A total of 123 patients with type 2 diabetes were divided into three groups,including D1 group（ less than 5 years group,43 cases）,D2 group（ 5-15 years group,51 cases） and D3 group（ more than 15 years group,29 cases） according to the course,40 subjects with normal glucose tolerance were included as control group. Moreover,diabetic patients were divided into two groups according to the uc OC concentration. The associations of uc OC and serum glucose level as well as lipid metabolic indexes were examined. Results（ 1） Compared with control group,serum uc OC level was significantly reduced in diabetic group [（ 0. 43±0. 35） mg/L vs.（ 1. 52±0. 88） mg/L]. But the serum triglyceride（ TG）level in diabetic group was higher than that in the control group [（ 2. 24±1. 64） mmol/L vs.（ 1. 44±0. 76） mmol/L].（ 2） For diabetic patients,serum uc OC level was negatively correlated to glycosylated hemoglobin（ Hb A1 c） and TG（ P = 0. 005,P =0. 008）. And Hb A1 c was negatively correlated to serum fasting c-peptide（ FCP）（ P = 0. 009）,and positively correlated to β-C-terminal telopeptide of type 1 collagen（ CTX）（ P = 0. 016）. Conclusion Serum uc OC could regulate glucose and lipid metabolism,and may pariticipate in the onset of type 2 diabetes.