胰岛素样生长因子-1表达水平在2型糖尿病并发骨质疏松症中的临床意义

Expression of insulin-like growth factor-1 in type 2 diabetes mellitus with osteoporosis

目的探讨胰岛素样生长因子-1(IGF⁃1)在2型糖尿病(T2DM)并发骨质疏松症(OP)中的表达意义。方法收集桂平市人民医院2017年1月至2019年12月收治的T2DM合并OP患者100例(T2DM+OP组),另取同期收治的单纯T2DM患者73例(T2DM组),单纯OP患者62例(OP组)及健康体检人员50名(健康对照组),比较各组Ⅰ型胶原羧基端肽β特殊序列(β⁃CTx)、骨钙素、骨形态发生蛋白(BMP)、血清Ⅰ型前胶原氨基端肽原(PINP)、骨密度(BMD)及IGF⁃1水平,采用Pearson法分析IGF⁃1表达水平与β⁃CTx、骨钙素、BMP、PINP、BMD的相关性。结果四组BMP、骨钙素、BMD、IGF⁃1呈逐渐下降趋势,且健康对照组>T2DM组>OP组>T2DM+OP组,差异有统计学意义(P<0.05);T2DM+OP组BMP、骨钙素、BMD、IGF⁃1明显低于OP组、T2DM组、健康对照组,差异有统计学意义(P<0.05)。四组β⁃CTx、PINP呈逐渐升高趋势,且健康对照组<T2DM组<OP组<T2DM+OP组,差异有统计学意义(P<0.05);T2DM+OP组β⁃CTx、PINP明显高于OP组、T2DM组、健康对照组,差异有统计学意义(P<0.05)。T2DM合并OP患者血清IGF⁃1表达水平与BMP、骨钙素、BMD呈正相关(r=0.385、0.622、0.507,P均<0.05);与β⁃CTx、PINP呈负相关(r=-0.371、-0.314,P均<0.05)。结论血清IGF⁃1表达水平与T2DM并发OP密切相关,可作为T2DM并发OP的早期诊断指标。

Objective To explore the expression significance of insulin⁃like growth factor⁃1(IGF⁃1)in type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP).Methods A total of 100 T2DM patients with OP(T2DM+OP group)admitted to Guiping People's Hospital from January 2017 to December 2019 were collected.In addition,73 patients with T2DM only(T2DM group)and 62 patients with OP(OP group)and 50 healthy physical examination personnel(healthy control group)were also enrolled for this study.The specific sequence of beta C⁃terminal cross⁃linked telopeptides of type I collagen(β⁃CTx),osteocalcin,bone morphogenetic protein(BMP),and serum procollagen type I N⁃terminal propeptide(PINP),bone mineral density(BMD)and IGF⁃1 in each group were compared.Pearson method was used to analyze the correlation between the expression level of IGF⁃1 and the levels ofβ⁃CTx,BMP,osteocalcin,PINP,BMD.Results BMP,osteocalcin,BMD,and IGF⁃1 of these four groups showed a gradual downward trend:healthy control group>T2DM group>OP group>T2DM+OP group;the differences were statistically significant(P<0.05);BMP,osteocalcin,BMD,and IGF⁃1 of T2DM+OP group were significantly lower than those in OP group,T2DM group,and healthy control group(P<0.05).β⁃CTx and PINP of the four groups showed a gradual increase:the healthy control group<T2DM group<OP group<T2DM+OP group;the differences were statistically significant(P<0.05);β⁃CTx and PINP of the T2DM+OP group were significantly higher than those in OP group,T2DM group and healthy control group(P<0.05).Serum IGF⁃1 expression in patients with T2DM and OP was positively correlated with BMP,osteocalcin,and BMD(r=0.385,0.622,0.507,P<0.05),but it was negatively correlated withβ⁃CTx and PINP(r=-0.371,-0.314,P<0.05).Conclusion The expression level of serum IGF⁃1 was closely related to T2DM complicated with OP,and it could be used as an early diagnosis index for T2DM complicated with OP.