骨折后血清骨钙素N端中分子片段与糖代谢指标的相关性分析

Correlation between serum N-terminal mid-fragment of osteocalcin and index of glucose metabolism after fracture

目的探讨骨折后血清骨钙素N端中分子片段(N-MID OC)与糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)、C-肽(C-P)的相关性。方法采用回顾性研究方法,将196例单一闭合性骨折男性患者纳入骨折组,将64例健康男性纳入健康对照组,比较2组的一般资料和生化指标水平。将骨折患者按N-MID OC四分位数分为4个亚组,比较4组患者HbA1c、FPG、FINS、C-P水平。分析血清N-MID OC水平与糖代谢指标及生化指标的相关性。结果骨折组年龄、体质量指数、血肌酐、HbA1c与健康对照组比较,差异无统计学意义(P>0.05);骨折组白细胞、谷丙转氨酶、谷草转氨酶、FPG、FINS、C-P水平高于健康对照组,血小板、血红蛋白、钙离子、25-羟维生素D;和N-MID OC水平低于健康对照组,差异有统计学意义(P<0.05)。不同亚组骨折患者的年龄和血小板、FPG、N-MID OC水平比较,差异有统计学意义(P<0.05)。相关性分析显示,N-MID OC与年龄(r=-0.280,P<0.001)、HbA1c(r=-0.081,P=0.011)、FPG(r=-0.196,P=0.006)均呈负相关;调整年龄因素后,多元线性回归分析显示,FPG是单一闭合性骨折患者血清N-MID OC的独立影响因素(β=-0.147,P=0.036,95%CI为-0.663~-0.023)。结论骨折创伤后糖代谢与血清N-MID OC存在相关性,这可能是影响骨代谢的因素。

Objective To investigate the relationships between serum N-terminal mid-fragment of osteocalcin(N-MID OC)and hemoglobin A1 c(HbA1 c),fasting plasma glucose(FPG),fasting insulin(FINS)and C-peptide(C-P).Methods A total of 196 male patients with single closed fracture were included in fracture group and 64 healthy men in healthy control group based on a retrospective study method,and the general data and biochemical indexes of the two groups were compared.The fracture patients were divided into four subgroups according to N-MID OC quartile,and the levels of HbA1 c,FPG,FINS and C-P in four groups were compared.The correlations of serum N-Mid OC level with glucose metabolism and biochemical indexes were analyzed.Results There were no differences in age,body mass index,serum creatinine and HbA1 c between the fracture group and the healthy control group(P>0.05).Leukocyte,alanine aminotransferase,aspartate aminotransferase,FPG,FINS,C-P in the fracture group were higher than those in the healthy control group,while platelets,hemoglobin,calcium ions,the levels of 25-hydroxyvitamin D;and N-MID OC levels were lower than those of the healthy control group(P<0.05).There were significant differences in age,platelets,FPG,and N-MID OC in the subgroups(P<0.05).Correlation analysis showed that serum N-MID OC was negatively correlated with age(r=-0.280,P<0.001),Hb A1 c(r=-0.081,P=0.011)and FPG(r=-0.196,P=0.006).After adjusting for age factor,multiple linear regression analysis showed that FPG was an independent factor affecting serum N-MID OC of patients with single closed fracture(β=-0.147,P<0.001,95%CI,-0.663 to-0.023).Conclusion There is a correlation between glucose metabolism and serum N-MID OC after fracture,which may be a factor affecting bone metabolism.