单核细胞/高密度脂蛋白胆固醇比值、成纤维细胞生长因子21、C肽表达水平与2型糖尿病性骨质疏松症相关性分析

Correlation between the expression levels of MHR,FGF21,C peptide and type 2 diabetic osteoporosis

目的:分析单核细胞/高密度脂蛋白胆固醇比值(MHR)、成纤维细胞生长因子21(FGF21)、C肽表达水平与2型糖尿病(T2DM)性骨质疏松症患者的相关性。方法:选取收治的T2DM性骨质疏松症患者90例为研究组,选取同期治疗的单纯T2DM患者57例为对照组。比较两组一般资料、骨钙素(BGP)、25羟基维生素D3[25(OH)D3]、Ⅰ型前胶原N端前肽(PINP)、MHR、FGF21、C肽水平差异;采用Spearman秩相关分析MHR、FGF21、C肽与患者骨代谢指标[BGP、25(OH)D3、PINP]的相关性;多元Logistic回归分析影响T2DM患者发生骨质疏松症的危险因素;绘制ROC曲线评价MHR、FGF21、C肽及三者联合检测对T2DM患者发生骨质疏松症的诊断价值。结果:研究组女性占比率高于对照组(P<0.05);相较于对照组,研究组MHR水平更高,而BGP、25(OH)D3、PINP、FGF21及C肽水平更低(均P<0.05);Spearman相关性分析显示,MHR与BGP、25(OH)D3、PINP均呈负相关(均P<0.05),FGF21及C肽与BGP、25(OH)D3、PINP均呈正相关(均P<0.05);多元Logistc分析显示,MHR是T2DM患者发生骨质疏松症的危险因素(P<0.05);FGF21及C肽是T2DM患者发生骨质疏松症的保护因素(均P<0.05);ROC曲线显示,MHR、FGF21、C肽及三者联合检测预测T2DM患者发生骨质疏松的曲线下面积分别为0.894、0.759、0.810、0.969。结论:T2DM骨质疏松症患者MHR水平上升,FGF21、C肽水平下降,且上述指标与患者骨质疏松密切相关,通过联合检测MHR、FGF21、C肽三者水平对于预测T2DM患者发生骨质疏松具有较好的应用价值。

Objective:To analyze the correlation between monocyte/high-density lipoprotein cholesterol ratio(MHR),fibroblast growth factor 21(FGF21),C-peptide expression levels and osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 90 patients with T2DM osteoporosis were selected as the study group,and 57 patients with simple T2DM treated in the hospital during the same period were selected as the reference group.The general data,osteocalcin(BGP),25-hydroxyvitamin D3[25(OH)D 3],N-terminal propeptide of typeⅠprocollagen(PINP),MHR,FGF21 and C-peptide levels were compared between the two groups.Spearman rank correlation was used to analyze the correlation between MHR,FGF21,C-peptide and BGP,25(OH)D 3,PINP.Multivariate Logistic regression analysis was used to analyze the risk factors of osteoporosis in T2DM patients.ROC curve was drawn to evaluate the diagnostic value of MHR,FGF21,C-peptide and their combined detection for osteoporosis in patients with T2DM.Results:The proportion of women in the study group was higher than that in the reference group(P<0.05).The level of MHRin the study group was higher than that in the reference group,and the levels of BGP,25(OH)D 3,PINP,FGF21 and C-peptide were lower than those in the reference group(all P<0.05).Spearman correlation analysis showed that MHRwas negatively correlated with BGP,25(OH)D 3 and PINP,while FGF21 and C-peptide were positively correlated with BGP,25(OH)D 3 and PINP(all P<0.05).Multivariate Logistic regression analysis showed that MHRwas a risk factor for osteoporosis in T2DM patients,and FGF21 and C-peptide were protective factors for osteoporosis in T2DM patients(all P<0.05).The results of ROC curve showed that the area under the curve of MHR,FGF21,C-peptide and their combined detection in predicting osteoporosis in T2DM patients was 0.894,0.759,0.810 and 0.969,respectively.Conclusion:The level of MHRin T2DM patients with osteoporosis increases,the levels of FGF21 and C-peptide decrease,and the above indicators are closely related to osteoporosis in T2DM patients.The combined detection of MHR,FGF21 and C-peptide levels has a good application value in predicting osteoporosis in T2DM patients.