2型糖尿病患者血清Metrnl水平与骨密度的相关性研究

Correlation between serum Metrnl level and bone mineral density in patients with type 2 diabetes mellitus

目的 探讨2型糖尿病(diabetes mellitus type 2,T2DM)患者血清Metrnl浓度与骨密度的相关性及其影响因素。方法 选取江苏大学附属医院就诊的T2DM患者146例,对所有受试者进行糖耐量、胰岛素兴奋实验、血生化检测等。ELISA检测血清Metrnl水平。所有受试者均接受双能X线骨密度仪检测,根据骨密度结果分为T2DM合并骨密度(bone mineral density, BMD)正常组和BMD异常组。结果 与T2DM合并BMD正常组相比,T2DM合并BMD异常组血清Metrnl水平显著升高(P<0.05)。进一步在调整性别、年龄等因素后,T2DM患者血清Metrnl水平与第1腰椎(L1)、L2、L3、L2~L4、L1~L4等BMD值,以及L1~L4 T值呈显著负相关(P<0.05)。Logistic回归结果显示,T2DM患者血清Metrnl水平与骨量异常独立相关。ROC曲线模型分析结果显示,血清Metrnl预测T2DM患者骨量异常的曲线下面积为0.720(95%CI=0.638~0.802,P<0.001)。结论T2DM合并BMD异常患者血清Metrnl水平显著增高,提示Metrnl水平可能在T2DM合并骨质疏松症的发生发展中起到一定作用。

Objective To investigate the correlation between serum Metrnl concentration and bone mineral density(BMD)in patients with type 2 diabetes mellitus and its influencing factors.Methods A total of 146 patients with type 2 diabetes mellitus in our hospital were selected.The glucose tolerance,insulin stimulation test,and blood biochemical test were performed.Serum Metrnl level was detected using ELISA.BMD was tested with dual energy X-ray absorptiometry in all the subjects.Patients were divided into two groups according to the result of BMD,type 2 diabetes mellitus with normal BMD group and abnormal BMD group.Results The level of serum Metrnl in type 2 diabetes mellitus with abnormal BMD group was significantly higher than that in type 2 diabetes mellitus with normal BMD group(P<0.05).After further adjustment of gender and age,the serum Metrnl level in type 2 diabetic patients was still significantly negatively correlated with BMD values of L1,L2,L3,L2-L4,L1-L4,and T values of L1-L4(P<0.05).Logistic regression result showed that serum Metrnl level was independently correlated to abnormal bone mass in type 2 diabetic patients.The ROC curve model analysis result showed that the area under the curve of serum Metrnl predicting abnormal bone mass in patients with type 2 diabetes was 0.720(95%CI=0.638-0.802,P<0.001).Conclusion The level of serum Metrnl and abnormal BMD increase significantly in patients with type 2 diabetes mellitus,suggesting that the level of Metrnl plays a role in the occurrence and development of osteoporosis with type 2 diabetes mellitus.