Hcy、BGP及CTX水平与T2DM合并骨质疏松患者血管钙化的关系

Relationship between Hcy,BGP and CTX levels and vascular calcification in patients with T2DM complicated with osteoporosis

目的分析同型半胱氨酸(Hcy)、骨钙素(BGP)及Ⅰ型胶原C端肽(CTX)水平与2型糖尿病(T2DM)合并骨质疏松患者血管钙化的关系。方法选取2020年5月至2022年9月徐州医科大学附属医院收治的129例T2DM合并骨质疏松患者为研究对象,将其纳入观察组。另选取同期体检骨量正常的121例T2DM患者,将其纳入对照组,对比两组Hcy、BGP及CTX水平。根据是否发生血管钙化将观察组患者分为钙化组和非钙化组,分析影响T2DM合并骨质疏松患者发生血管钙化的危险因素,ROC曲线分析Hcy、BGP及CTX对T2DM合并骨质疏松患者发生血管钙化的预测价值。结果观察组患者血清Hcy、CTX、BGP水平高于对照组,差异具有统计学意义(P<0.05)。129例患者中,发生钙化者27例。钙化组与非钙化组患者的性别、年龄、吸烟饮酒史、BMI、钙、磷、维生素D比较,差异无统计学意义(P>0.05)。钙化组与非钙化组患者Hcy、BGP及CTX水平比较,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,血清Hcy、BGP及CTX水平是T2DM合并骨质疏松患者发生血管钙化的独立危险因素(P<0.05)。依据ROC曲线可知,Hcy、BGP及CTX联合检测T2DM合并骨质疏松患者发生血管钙化的敏感度和特异度分别为0.852和0.823;AUC=0.858(95%CI:0.778~0.938),明显高于Hcy、BGP及CTX单独检测。结论Hcy、BGP及CTX表达异常是T2DM合并骨质疏松患者血管钙化的影响因素,密切监测三者水平变化,可为早期明确T2DM合并骨质疏松患者是否发生血管钙化提供临床依据。

Objective To analyze the relationship between the levels of homocysteine(Hcy),osteocalcin(BGP)and typeⅠcollagen C⁃telopeptide(CTX)and vascular calcification in patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis.Methods 129 T2DM patients with osteoporosis admitted to the Affiliated Hospital of Xuzhou Medical University from May 2020 to September 2022 were selected as the research subjects,and were included in the observation group.Another 121 T2DM patients with normal bone mass in the same period of physical examination were selected,and were included in the control group,and the levels of Hcy,BGP and CTX were compared between the two groups.According to the occurrence of vascular calcification,the patients in the observation group were divided into the calcification group and the non⁃calcification group,and the risk factors affecting the occurrence of vascular calcification in T2DM patients with osteoporosis were analyzed.Results The levels of serum Hcy,CTX,and BGP in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Among 129 patients,27 had calcification.There was no significant difference in gender,age,smoking and drinking history,BMI,calcium,phosphorus,and vitamin D between the calcification group and the non⁃calcification group(P>0.05).There were statistically significant differences in the levels of Hcy,BGP and CTX between the calcification group and the non⁃calcification group(P<0.05).Logistic regression analysis showed that serum Hcy,BGP and CTX levels were independent risk factors for vascular calcification in T2DM patients with osteoporosis(P<0.05).According to the ROC curve,the sensitivity and specificity of Hcy,BGP and CTX combined detection of vascular calcification in T2DM patients with osteoporosis were 0.852 and 0.823;AUC=0.858(95%CI:0.778~0.938),which was significantly higher than that of Hcy,BGP and CTX detected alone.Conclusion The abnormal expression of Hcy,BGP and CTX is the influencing factor of vascular calcification in patients with T2DM and osteoporosis,and closely monitor the changes of the three levels to provide clinical basis for early identification of vascular calcification in patients with T2DM and osteoporosis.