端粒长度及血浆晚期糖基化终末产物对2型糖尿病患者骨密度的影响

Effects of telomere length and plasma AGEs on bone mineral density in type 2 diabetic patients

目的研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者外周血白细胞端粒长度以及血浆晚期糖基化终末产物(advanced glycosylation end products,AGEs)水平与骨密度(bone mineral density,BMD)之间的关系以及晚期糖基化终末产物水平对端粒长度的影响。方法选取2023年5月1日至2024年5月1日期间就诊于郑州市中心医院内分泌科的T2DM并行双能X线BMD检查的患者174例,将T2DM患者根据BMD中T值分为骨质疏松组、骨量减少组、骨量正常组。采取qPCR法测定外周血白细胞端粒长度、ELISA法测定AGEs水平。收集所有患者的一般资料,检测血糖、血脂、25羟基维生素D3[25(OH)D3]等指标,采用双能X线测定BMD、ELISA法测定血浆Ⅰ型胶原羧基端肽(CTX)、Ⅰ型前胶原N端前肽(PINP)水平,应用SPSS26.0统计学软件分析各指标的组间差异和相关性。结果(1)骨质疏松组、骨量减少组、骨量正常组端粒长度、AGEs水平均存在差异,三组端粒长度依次增加,AGEs水平依次降低。(2)T2DM患者端粒长度与各部位BMD呈正相关,与CTX、PINP呈负相关,血浆AGEs水平与各部位BMD呈负相关,与CTX、PINP正相关,且端粒长度与AGEs水平负相关。(3)端粒长度是各部位BMD的独立影响因素,AGEs水平是各部位BMD的独立影响因素(P<0.05)。结论T2DM患者端粒长度缩短、AGEs水平升高均与BMD降低相关,并且端粒长度缩短与AGEs水平上升有关。外周血白细胞端粒长度及血浆AGEs水平可以共同评价T2DM患者的骨代谢状态。

Objective To investigate the correlation between telomere length of peripheral white blood cells and the levels of advanced glycosylation end products,as well as bone mineral density in patients with type 2 diabetes mellitus,and to assess the impact of advanced glycosylation end product levels on telomere length.Methods From May 1,2023,to May 1,2024,174 patients with T2DM who underwent dual-energy X-ray BMD examination at the Department of Endocrinology,Zhengzhou Central Hospital,were selected.T2DM patients were divided into osteoporosis group,osteopenia group,and normal bone mass group based on the T-value in BMD.qPCR method was used to measure telomere length in peripheral blood leukocytes,and ELISA method was used to determine AGEs levels.General patient data were collected along with measurements for blood glucose,blood lipid levels,25-hydroxy-vitamin D,and other indicators.Bone mineral density was evaluated using dual-energy X-ray imaging while plasma CTX and PINP levels were measured via ELISA.SPSS 26.0 statistical software was utilized to analyze differences and correlations among all indicators.Results(1)The telomere length of OP group,osteopenia group and normal bone mass group was different,and the telomere length of the three groups increased successively.(2)In individuals with type 2 diabetes mellitus,telomere length exhibited a positive correlation with BMD and a negative correlation with CTX and PINP.Plasma AGEs level showed a negative correlation with BMD and a positive correlation with CTX and PINP,while telomere length demonstrated a negative correlation with AGEs level.(3)Telomere length was an independent factor of BMD,and AGEs level was an independent factor of BMD(P<0.05).Conclusion The reduction of telomere length and the increase of AGEs in patients with type 2 diabetes are related to the decrease of bone mineral density,and the reduction of telomere length is related to the increase of AGEs.Telomere length of peripheral leucocytes and plasma AGEs level can jointly evaluate the bone metabolism status of T2DM patients.