糖尿病患者内脏脂肪面积、血清PTH、趋化素的变化及其与骨密度的关系

Changes of visceral fat area,serum PTH,and Chemerin in patients with diabetes mellitus and their relationship with bone mineral density

目的检测糖尿病患者内脏脂肪面积(VFA)、血清甲状旁腺激素(PTH)、趋化素(Chemerin)水平,并分析其与骨密度(BMD)的关系。方法前瞻性选取2021年10月至2023年10月驻马店市中心医院收治的101例糖尿病患者,根据BMD结果分为骨量正常组(n=36)、骨量减少组(n=33)和骨质疏松组(n=32),选取同期骨量正常的健康体检者为对照组(n=35)。比较四组受检者的基线资料、血清指标和不同部位骨骼的BMD,采用Pearson相关检验分析VFA、PTH、Chemerin与糖尿病患者L1~4BMD、股骨颈BMD、Wards三角BMD、全髋BMD的相关性。结果四组受检者在腰围、腰臀比、VFA、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、PTH、Chemerin方面比较差异均有统计学意义(P<0.05);四组受检者在L1~4BMD、股骨颈BMD、Wards三角BMD、全髋BMD方面比较差异均有统计学意义(P<0.05);Pearson相关检验分析结果显示,VFA、PTH、Chemerin与糖尿病患者L1~4BMD、股骨颈BMD、Wards三角BMD、全髋BMD均呈明显负相关(P<0.05)。结论糖尿病患者VFA明显增加,血清PTH、Chemerin水平明显上升,且VFA增加及血清PTH、Chemerin水平上升与糖尿病患者发生骨质疏松紧密相关。

Objective To detect the levels of visceral fat area(VFA),serum parathyroid hormone(PTH),and chemokine in patients with diabetes mellitus,and to analyze their relationship with bone mineral density(BMD).Methods A total of 101 patients with diabetes mellitus admitted to Zhumadian Central Hospital from October 2021 toOctober 2023 were prospectively selected and divided into normal bone mass group(n=36),osteopenia group(n=33),and osteoporosis group(n=32)according to the BMD results.Healthy people with normal bone mass were selected asthe control group(n=35).The baseline data,serum indicators,and bone BMD of different parts were compared amongthe four groups.Pearson correlation test was used to analyze the correlation between VFA,PTH,Chemerin and lumbarspine L1-4 BMD,femoral neck BMD,Wards triangle BMD,and total hip BMD in patients with diabetes mellitus.Results There were statistically significant differences in waist circumference,waist to hip ratio,VFA,fasting bloodglucose(FPG),glycated hemoglobin(HbAlc),insulin resistance index(HOMA-IR),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),PTH,and Chemerin among the four groups of subjects(P<0.05).The differences in lumbar spine L1-4 BMD,femoral neck BMD,Wards triangle BMD,and total hip BMD amongthe four groups of subjects were statistically significant(P<0.05).Pearson correlation analysis showed that VFA,PTH,Chemerin were significantly negatively correlated with lumbar L1-4 BMD,femoral neck BMD,Wards triangle BMD,andtotal hip BMD in patients with diabetes mellitus(P<0.05).Conclusion VFA,serum PTH,and Chemerin levels in patientswith diabetes mellitus increased significantly,and the increase of VFA,serum PTH,and Chemerin levels wasclosely related to osteoporosis in patients with diabetes mellitus.