2型糖尿病患者骨代谢标志物变化的研究

A Study on the Variation Characteristics of Bone Metabolism Markers in Type 2 Diabetes Mellitus Patients

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨代谢标志物的变化及其与血糖、血脂代谢的相关性。方法选取203例T2DM患者作为研究对象,选取同期体检的210例健康人作为对照组,分别测定各组骨代谢指标包括25-羟维生素D[25-hydroxyvitamin D,25(OH)D]、总Ⅰ型胶原氨基端延长肽(totalⅠtype collagen amino peptide,TP1NP)、骨钙素(osteocalcin,BGP)、β胶原特殊序列(beta isomerized C telopeptide,β-CTX)等,血糖指标包括糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting blood glucose,FBG)等,钙磷代谢指标包括钙离子(calcium ions,Ca2+)、磷(phosphorus,P)等、脂代谢指标包括三酰甘油(triglyceride,TG)、胆固醇(cholesterol,CHO)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)、载脂蛋白A1(apolipoprotein A1,APOA1)、载脂蛋白B(apolipoprotein B,APOB)等水平,分析T2DM患者25(OH)D、TP1NP、BGP、及β-CTX与其余各指标的相关性。结果T2DM组患者TP1NP、BGP、β-CTX、25(OH)D、Ca2+、CHO、LDL、HDL、APOA1水平均低于对照组(P<0.05),HbA1c、FBG、P、TG水平高于对照组(P<0.05),APOB水平在两组差异无统计学意义(P>0.05)。Spearman相关分析结果显示,T2DM患者25(OH)D水平与FBG、TG、CHO、LDL呈负相关(P<0.05),BGP水平与P、HDL、APOA1呈正相关(P<0.05),TP1NP、β-CTX水平与各指标无相关性(P>0.05)。结论T2DM患者骨代谢标志物水平变化显著,25(OH)D及BGP可能参与血糖及血脂代谢调节过程。

Objective To detect the levels of bone metabolism markers in type 2 diabetes mellitus(T2DM)patients and explore their relationship with glycometabolism and lipometabolism.Methods A total of 203 T2DM patients were selected as our research subjects,while 210 healthy persons who underwent body examination at the same time were selected as the control group.The levels of bone metabolism markers,including 25-hydroxyvitamin D[25(OH)D],totalⅠtype collagen amino peptide(TP1NP),osteocalcin(BGP),beta isomerized C telopeptide(β-CTX),and blood sugar indexes,including glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),and calcium and phosphorus metabolism indexes,including calcium ions(Ca2+),phosphorus(P),and lipid metabolism indexes,including triglyceride(TG),cholesterol(CHO),low density lipoprotein(LDL),high density lipoprotein(HDL),apolipoprotein A1(APOA1),and apolipoprotein B(APOB)were detected among all subjects,and the relationship between bone metabolism markers and other indexes in T2DM patients were analyzed.Results The levels of TP1NP,BGP,β-CTX,25(OH)D,Ca2+,CHO,LDL,HDL,and APOA1 in T2DM patients were significantly lower than those in the control group(P<0.05),while the levels of HbA1c,FBG,P,and TG in T2DM patients were significantly higher than those in the control group(P<0.05),and there was no significant difference in APOB between 2 groups(P>0.05).The results of Spearman correlation analysis showed that 25(OH)D was negatively correlated with FBG,TG,CHO,and LDL(P<0.05),while BGP was positively correlated with P,HDL,and APOA1 in T2DM patients(P<0.05),and TP1NP andβ-CTX were not correlated with other indexes(P>0.05).Conclusion The levels of bone metabolism markers in T2DM patients changed significantly,and 25(OH)D and BGP could be involved in the regulation of blood sugar and lipid metabolism.