Ⅱ型糖尿病患者血清25(OH)D_(3)、Vaspin、chemerin与甲状腺功能与骨密度的相关性

Correlation of Serum 25(OH)D_(3),Vaspin,Chemerin with Thyroid Function and Bone Density in Patients with Type 2 Diabetes Mellitus

目的分析Ⅱ型糖尿病患者血清25-羟基维生素D_(3)[25(OH)D_(3)]、腹腔脂肪型丝氨酸蛋白酶抑制剂(Vaspin)、趋化素(chemerin)与其甲状腺功能以及骨密度之间的相关性。方法随机选择2023年1月至2024年3月平顶山市第一人民医院内分泌代谢科收治的125例Ⅱ型糖尿病患者进行调查分析,收集患者的基本资料,统计患者空腹血糖(FPG)、空腹胰岛素(FIN)、甘油三酯(TG)、总胆固醇(TC)、促甲状腺激素(TSH)、血清游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、骨密度(BMD)和血清25(OH)D_(3)、Vaspin、chemerin水平。结果纳入研究的患者以男性患者为主,平均年龄(53.76±7.72)岁,平均病程(10.68±5.23)年,平均体质量指数(BMI)(24.79±2.13)kg/m~2,多数患者合并高血压(39.20%)或高血脂(34.40%),少部分患者有糖尿病家族史(27.20%)。在临床指标方面,纳入的研究对象FPG、FIN、chemerin均值与正常范围相比增高,25(OH)D_(3)、腰椎BMD和股骨颈BMD均值与正常范围相比降低,而TG、TC、TSH、FT_(3)、FT_(4)、Vaspin处于正常范围。相关性分析结果显示,血清25(OH)D_(3)、Vaspin和chemerin水平与FPG、FIN、TG、TC、TSH、FT_(3)、FT_(4)、腰椎BMD和股骨颈BMD之间存在相关性,差异均有统计学意义(P<0.05);其中血清25(OH)D_(3)和Vaspin与FPG、FIN、TG、TC、FT_(3)结果呈负相关关系,而与TSH、FT_(4)、腰椎BMD、股骨颈BMD呈正相关关系;而血清chemerin与TSH、FT_(4)、腰椎BMD、股骨颈BMD结果呈负相关关系,而与FPG、FIN、TG、TC、FT_(3)呈正相关关系。结论Ⅱ型糖尿病患者的血清25(OH)D_(3)、Vaspin、chemerin水平与其甲状腺功能指标以及骨密度存在一定相关性,因此临床可根据患者血清25(OH)D_(3)、Vaspin、chemerin的表达情况以及具体症状表现评估患者出现甲状腺功能障碍或骨质疏松风险,及时采取针对性干预措施。

Objective To analyze the correlation of serum 25-hydroxyvitamin D3[25(OH)D_(3)],visceral adipose tissue-derived serine protease inhibitor(Vaspin),and chemerin with thyroid function and bone density in patients with type 2 diabetes mellitus.Methods A total of 125 Type 2 diabetes mellitus patients treated at the Department of Endocrinology and Metabolism,The First People’s Hospital of Pingdingshan from January 2023 to March 2024 were randomly selected for investigation and analysis.Basic patient information was collected,and fasting plasma glucose(FPG),fasting insulin(FIN),triglycerides(TG),total cholesterol(TC),thyroid-stimulating hormone(TSH),serum free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),bone mineral density(BMD),and serum 25(OH)D3,Vaspin,and chemerin levels were measured.Results The study included predominantly male patients with an average age of 53.76±7.72 years,an average disease duration of 10.68±5.23 years,and an average body mass index(BMI)of 24.79±2.13 kg/m^(2).Most patients had hypertension(39.20%)or hyperlipidemia(34.40%),and a few had a family history of diabetes(27.20%).Clinically,the mean values of FPG,FIN,and chemerin were higher than the normal range,while the mean values of 25(OH)D_(3),lumbar spine BMD,and femoral neck BMD were lower than the normal range.TG,TC,TSH,FT_(3),FT_(4),and Vaspin were within the normal range.Correlation analysis showed that serum 25(OH)D_(3),Vaspin,and chemerin levels were correlated with FPG,FIN,TG,TC,TSH,FT_(3),FT_(4),lumbar spine BMD,and femoral neck BMD,with statistically significant differences(P<0.05).Serum 25(OH)D_(3) and Vaspin were negatively correlated with FPG,FIN,TG,TC,and FT3,and positively correlated with TSH,FT4,lumbar spine BMD,and femoral neck BMD.Serum chemerin was negatively correlated with TSH,FT_(4),lumbar spine BMD,and femoral neck BMD,and positively correlated with FPG,FIN,TG,TC,and FT_(3).Conclusion Serum 25(OH)D_(3),Vaspin,and chemerin levels in Type 2 diabetes mellitus patients are correlated with thyroid function indicators and bone density.Clinically,the expression levels of serum 25(OH)D_(3),Vaspin,and chemerin,along with specific symptoms,can be used to assess the risk of thyroid dysfunction or osteoporosis in patients,allowing for timely targeted interventions.