戒烟对男性2型糖尿病患者骨代谢的影响

Effect of smoking cession on bone metabolism in male patients with type 2 diabetes

目的探讨戒烟对男性2型糖尿病(T2DM)患者骨代谢的影响。方法收集332例男性T2DM患者,其中不吸烟组91例、吸烟组163例及戒烟组78例,并根据戒烟时间和年龄进行分层分析。结果 3组间β-胶原特殊序列(β-CTx)、N-端骨钙素(NTOC)、总I型胶原氨基端延长肽(P1NP)及血清碱性磷酸酶(ALP)相比较,吸烟组数值最大,β-CTx与吸烟状况呈正相关(P<0.05);戒烟时间最长组的β-CTx、NTOC、P1NP及ALP数值最小,且戒烟时间与β-CTx、NTOC、P1NP及ALP呈负相关(均P<0.05);年龄<60岁患者中,戒烟组与吸烟组相比,β-CTx、NTOC、P1NP及ALP明显降低,差异均有统计学意义(均P<0.05)。结论吸烟可导致T2DM男性的骨吸收指标β-CTx和骨形成指标NTOC、P1NP及ALP增高,β-CTx增高更为明显,在非老年的男性T2DM患者中,戒烟后这种影响是可逆的,随着戒烟时间的延长骨代谢指标改善更为明显。

Objective To examine the effect of smoking cession on bone metabolism in male patients with type 2 diabetes（T2 DM）.Methods The clinical data of 332 male patients with T2 DM admitted in Zhejiang Hospital were retrospectively reviewed, including 91 non-smokers, 163 current smokers and 78 former smokers. Stratified analysis was conducted according to quitting time and age of patients.Results The values of β-crosslaps（β-CTx）, N-terminal osteocalcin（NTOC）, procollagen type 1 N-terminal propeptide（P1NP） and serum alkaline phosphatase（ALP） were highest in the current smokers among three groups; and β-CTx was significantly correlated with the smoking status（P〈0.05%）. The values of-CTx, NTOC, P1NP and ALP were lowest in patients with smoking cession ≥10 years; and smoking-cession time was negatively correlated with β-CTx, NTOC, P1NP and ALP levels（P〈0.05%）. In patients aged 60 years the β-CTx, NTOC,P1NP and ALP levels in former smokers were lower than those in current smokers（P〈0.05）. Conclusion Smoking status is associated with the increase of bone resorption marker β-CTx and bone formation markers NTOC, P1NP and ALP. The effects of smoking can be reversed by smoking cession in patients aged〈 60 years, and the longer duration of smoking cession the better improvement of bone metabolism.