鸢尾素、骨膜素及内脏脂肪面积与中老年男性2型糖尿病合并骨质疏松症相关性的研究

Correlation between Irisin,sPostn and visceral fat area and osteoporosis in middle-aged and elderly men with type 2 diabetes mellitus

目的探讨中老年男性T2DM合并骨质疏松(OP)的发病机制及与鸢尾素(Irisin)、骨膜素(sPostn)、内脏脂肪面积(VFA)的相关性。方法选取2021年3月至2021年12月于内蒙古科技大学包头医学院第一附属医院内分泌代谢科住院治疗的≥55岁中老年男性T2DM患者120例,按照T值≤-2.5为OP,-2.5<T值<-1.0为骨量减少,T值≥-1.0为骨量正常,分为OP组、骨量减少组、骨量正常组,每组各40例。比较各组一般资料、生化指标及骨代谢指标,检测腰椎、股骨颈骨密度(BMD),测量VFA与皮下脂肪面积(SFA),ELISA法检测血浆Irisin、sPostn。结果骨量正常、骨量减少、OP组DM病程、饮酒史、FPG、HbA1c、血尿酸(SUA)、VFA、SFA、sPostn依次升高(P<0.05),25羟基维生素D[25(OH)D]、Irisin、腰椎BMD、股骨颈BMD依次降低(P<0.05)。Spearman相关分析显示,腰椎、股骨颈BMD与25(OH)D、Irisin呈正相关(P<0.05),与VFA、sPostn呈负相关(P<0.05)。多元逐步回归分析显示,Irisin、25(OH)D、SUA、VFA是腰椎BMD的影响因素,Irisin、sPostn、25(OH)D、SUA、VFA是股骨颈BMD的影响因素。结论中老年男性T2DM患者Irisin低表达,sPostn高表达、VFA增大可能导致骨代谢异常及BMD降低,增加OP患病风险。

Objective To investigate the pathogenesis of type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP)in middle-aged and elderly men and its correlation with Irisin,sPostn and visceral fat area(VFA).Methods A total of 120 middle-aged and elderly male T2DM patients in Endocrinology and Metabolism Department of The First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology were collected in this study.All the patients were divided into OP group(n=40),osteopenia group(n=40)and normal bone mass group(n=40)according to T value.T value≤-2.5 was OP,-2.51c,SUA,VFA,SFA and sPostn were increased in turn(P<0.05),and 25(OH)D,Irisin,lumbar BMD and femoral neck BMD were decreased in turnin the normal bone mass group,osteopenia group,and OP group(P<0.05).Spearman correlation analysis showed that BMD of lumbar vertebrae and femoral neck was positively correlated with 25(OH)D and Irisin(P<0.05),while negatively correlated with VFA and sPostn(P<0.05).Multiple stepwise regression analysis showed that Irisin,25(OH)D,SUA and VFA were the influencing factors for lumbar BMD,while Irisin,sPostn,25(OH)D,SUA and VFA were the influencing factors for femoral neck BMD.Conclusion Low expression of Irisin,high expression of sPostn and increased VFA in middle-aged and elderly male T2DM patients may lead to abnormal bone metabolism,BMD reduction,and increased risk of OP.