2型糖尿病患者晚期糖基化终末代谢产物与骨代谢的相关性

Correlation between advanced glycation end-products and bone metabolism in type 2 diabetes patients

目的观察2型糖尿病(type 2 diabetes mellitus,T2DM)患者中,经皮肤测得的晚期糖基化终末代谢产物(advanced glycation end-products,AGEs)与骨代谢的相关性。方法根据AGEs水平将306例T2DM患者分成3组(T1:AGEs<80 AU,T2:80 AU≤AGEs<100 AU,T3:≥100 AU),其中T1组180例,T2组107例,T3组19例。采用双能X线吸收测定法测定股骨颈和腰椎1~4的骨密度,用电化学发光免疫分析测定骨转化指标。结果AGEs与I型胶原C端肽无相关性(r=-0.006,P=0.923),与骨钙素呈负相关(r=-0.14,P=0.026)。校正可能的混杂因素后,与T1组相比,T3组和T2组发生骨质疏松的危险度分别增加58%和14%。结论AGEs可能通过抑制成骨细胞的活动,对T2DM患者的骨代谢发挥一定的损害作用。

Objective To investigate the correlation between advanced glycation end-products(AGEs)detected by skin autofluorescence and bone metabolism in type 2 diabetes mellitus(T2DM).Methods A total of 306 T2DM patients were divided into three groups(T1,AGEs<80 AU;T2,80 AU≤AGEs<100 AU;and T3,AGEs≥100 AU)according to the AGEs level on the skin.There were 180,107,and 19 subjects in group T1,T2,and T3,respectively.Bone mineral density of the femur neck and lumbar vertebrae 1-4 were measured with dual-energy X-ray absorptiometry.Bone turnover biomarkers were detected with electrochemiluminescence method.Results No correlation was found between AGEs and collagen typeⅠβ-crosslinked C-telopeptide(r=-0.006,P=0.923).AGEs were negatively correlated with osteocalcin(r=-0.14,P=0.026).After adjusting for multiple confounders,further analysis revealed that compared with the T1 group,the odds for osteoporosis increased by 58%and 14%in the T3 and T2 groups,respectively.Conclusion AGEs may negatively impact bone metabolism by inhibiting osteoblast activity in T2DM patients.