骨转换标志物检测在2型糖尿病伴骨质疏松筛选中的应用

Application of bone turnover markers in detecting type 2 diabetes mellitus patients with osteoporosis

目的探讨骨转换标志物在2型糖尿病(T2DM)骨质疏松筛选中的检测意义。方法选取2016年7月~2017年12月于北京大学深圳医院(以下简称“我院”)就诊的66例2型糖尿病伴骨质疏松症患者(DOP组)、54例T2DM非合并骨质疏松患者(T2DM组)为研究对象,另选取我院进行健康体检的60名健康受试者为HP组。测定骨密度、骨转换生化标志物等指标,分析骨转换生化指标与病程的关系。结果与HP组比较,DOP与T2DM组骨密度降低(P<0.05),1型前胶原氨基端延长肽(P1NP)上升(P<0.05);P1NP与左侧股骨颈、股骨近端处骨密度呈负相关(r=-0.377、-0.415,P<0.05),β-CTx与股骨近端处骨密度呈负相关(r=-0.303,P<0.05);另外患者血糖控制是否良好、是否并发其他疾病与P1NP、β-CTx水平相关,差异有统计学意义(P<0.05)。结论检测骨转换标志物有助于T2DM伴骨质疏松症筛选。

Objective To explore the significance of bone conversion markers in the screening of type 2 diabetic osteoporosis.Methods Sixty-six patients with type 2 diabetes(T2DM)and osteoporosis(DOP group)and fifty-four patients with type 2 diabetes mellitus with no osteoporosis(T2DM group)admitted to Peking University Shenzhen Hospital(“our hospital”for short)from July 2016 to December 2017 were selected as research subjects.And sixty healthy subjects who underwent health examination in our hospital were selected as HP group.Bone mineral density,biochemical markers of bone conversion were measured,and the relationship between biochemical markers of bone conversion and disease course was analyzed.Results Compared with HP group,the bone mineral density in the DOP group and T2DM group was decreased,the serum levels of P1NP in the DOP group and T2DM group increased(P<0.05).It showed that P1NP was negatively correlated with bone mineral density at left femoral neck proximal femur(r=-0.415,-0.377,P<0.05),β-CTx was negatively correlated with bone mineral density at proximal femur(r=0.303,P<0.05).In addition,there was a positive correlation between patients'blood sugar control and whether there were other diseases with the levels of P1NP and β-CTx,the differences were statistically significant(P<0.05).Conclusion The detection of bone conversion markers is helpful for the screening of T2DM with osteoporosis.