2型糖尿病合并骨质疏松患者外周血中VDR mRNA表达与25(OH)D、甘油三酯的关系研究

Study on the relationship between the expression of VDR mRNA in peripheral blood and the levels of 25(OH)D and triglyceride in type 2 diabetes complicated with osteoporosis

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松(osteoporosis,OP)患者血浆中维生素D受体(vitamin D receptor,VDR)mRNA表达水平与25羟维生素D[25 hydroxyvitamin D,25(OH)D]、甘油三酯(triglyceride,TG)的关系。方法选取2016年6月至2017年5月就诊于遵义医科大学附属医院内分泌科门诊及住院治疗的初诊2型糖尿病患者100例,据骨密度(bone mineral density,BMD)测定结果分为:单纯T2DM组48例,T2DM合并骨质疏松组(T2DM+OP组)52例;选取遵义医科大学体检中心年龄及性别相匹配的健康对照者(NC组)90例。采用电化学发光法检测血清25(OH)D水平,全自动生化分析仪检测TG,采用实时荧光定量聚合酶链反应(Real Time-PCR)检测外周血中VDR mRNA表达水平。结果T2DM+OP组与单纯T2DM组相比,血浆中25(OH)D水平降低[(8.76±3.21)^(12.46±4.35) ng/mL,t=32.423,P=0.000],VDR mRNA表达水平降低[(0.35±0.12)^(1.07±0.23),t=15.365,P=0.001],而TG水平升高[(4.1±1.26)^(2.98±0.56) mmol/L,t=11.765,P=0.000];Pearson相关分析结果显示,血浆中VDR mRNA表达与25(OH)D水平呈正相关(相关系数r=0.717,P<0.05),与HbAlc、HOMA-IR、Fins、FPG、2hPG、TG呈负相关(相关系数r分别为-0.342、-0.353、-0.361、-0.546、-0.426、-0.342,P<0.05)。结论外周血中VDR mRNA表达、25(OH)D水平降低及TG水平的升高可能共同参与了T2DM、骨质疏松的发生发展。

Objective To investigate the relationship between plasma vitamin D receptor(VDR)mRNA expression and levels of 25(OH)D and triglyceride(TG)in patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis.Methods We selected 100 patients with newly diagnosed type 2 diabetes who were outpatients or inpatients of the Department of Endocrinology of Affiliated Hospital of Zunyi Medical College from June 2016 to May 2017.According to the result of bone mineral density(BMD),48 patients were in the T2DM alone group and 52 patients were in the T2DM with osteoporosis group(T2DM+OP group).Ninety healthy controls(NC group)matched by age and gender from the physical examination centre of Zunyi Medical College were selected.The level of serum 25(OH)D was detected by electrochemiluminescence,and TG was detected by an automatic biochemical analyzer.Real-time fluorescence quantitative polymerase chain reaction(Real Time-PCR)was used to detect the expression level of VDR mRNA in peripheral blood.Results Plasma 25(OH)D level decreased in T2DM+OP group compared with T2DM alone group[(8.76±3.21)vs(12.46±4.35)ng/mL,t=32.423,P=0.000],the expression level of VDR mRNA decreased[(0.35±0.12)vs(1.07±0.23),t=15.365,P=0.001]and TG level increased((4.1±1.26)vs(2.98±0.56)mmol/L,t=11.765,P=0.000)Pearson correlation analysis result showed that the plasma levels of VDR mRNA expression positively correlated with 25(OH)D levels(correlation coefficient r=0.717,P<0.05),and HbAlc,HOMA-IR,Fins,FPG and 2 HPG negatively correlated with TG(correlation coefficient r was-0.342,-0.353,-0.361,-0.546,-0.426 and-0.342,respectively;P<0.05).Conclusion The expression of VDR mRNA,the decrease of 25(OH)D levels and the increase of TG levels in peripheral blood may involve in the occurrence and development of T2DM and osteoporosis.