摘要
探讨血清骨代谢指标及骨密度检查在2型糖尿肾病中的临床应用。将诊断明确的44例2型糖尿病肾病(DN)组列为DN组,诊断明确的53例2型糖尿病(T2D)组列为T2D组,选40名查体健康者为对照(Con)组。用双能X线骨密度仪检查髋骨骨密度(BMD),罗氏全自动电化学发光分析仪检测血清骨Ⅰ型前胶原N端肽(P1NP)、Ⅰ型胶原羧基末端肽(β-CTX)、25-羟基维生素D[(25(OH)VD]、骨钙素(BGP)的水平,高效液相色谱法检测血浆糖化血红蛋白(HbA1C),统计结果并分析骨代谢指标与BMD、HbA1C间的相关性。结果显示,DN组及T2D组患者血清中HbA1C、β-CTX水平高于Con组,但BMD及血清BGP、P1NP、25(OH)VD水平低于Con组,有统计学意义(P<0.05);DN组BGP、P1NP、25(OH)VD、BMD水平下降和β-CTX增高的检出率较T2D组明显增多,有统计学意义(P<0.05)。Spearman分析发现DN组患者BMD与血清BGP、P1NP、25(OH)VD水平呈正相关,与血清β-CTX呈负相关;患者HbA1C水平与血清β-CTX呈正相关,与BGP呈负相关。结论提示DN患者血清骨代谢改变较T2D组和Con组明显,骨量减少更多,DN患者更容易发生骨质疏松症或骨折。
The clinic application of bone metabolism index and bone mineral density (BMD) check of serum in 2 nd diabetic nephropathy is discussed here.44 patients who have 2 nd diabetic nephropathy were in DN group,53 patients who have diabetes were in T2D group,and 40 healthy people were in Con group.Hip bone density was checked by dual energy X-ray bone density meter,bone 1 st type procollagen N peptide(P1NP) in serum,Ⅰtype collagen carboxyl terminal peptide(β-CTX),25-hydroxy vitamin D[(25(OH)-VD],the level of osteocalcin were checked by Roche automatic electrochemiluminescence analyzer.Plasma glycosylated hemoglobin(HbA 1C ) was checked by high efficiency liquid chromatography.Results were summarized and analyzed about the relationship between bone metabolic index and BMD,HbA 1C.The results show that HbA 1C,β-CTX level of patients in DN and T2D group were higher than that in Con,however,BMD and BGP,P1NP、25(OH)VD level in serum were less than that in Con,which has statistical significance( P <0.05).Level of BGP,P1NP,25(OH)VD and BMD in DN group were evidently higher than in T2D,as well as high β-CTX checked ratio,which has statistical significance( P <0.05) in Spearman analysis,in DN group,BMD was positive correlation to the level of BGP,P1NP and 25(OH)VD in serum,and negative correlation to β-CTX,HbA 1C level is positive correlation to β-CTX,negative correlation to BGP.As a result,the change of serum bone metabolism in patients of DN group were obvious than T2D and Con,and more bone are less,patients in DN are easily to have osteoporosis or fracture.
作者
王国芳
葛锁华
张欢妍
周丹
彭俊华
Wang Guofang;Ge Suohua;Zhang Huanyan;Zhou Dan;Peng Junhua(Department of Clinical Laboratory,Jintan District People's Hospital of Changzhou,Changzhou 213200,China)
出处
《甘肃科学学报》
2019年第4期79-83,共5页
Journal of Gansu Sciences
关键词
骨代谢
骨密度
糖尿病肾病
骨质疏松症
糖化血红蛋白
Bone metabolism
Bone density
Diabetic nephropathy
Osteoporosis
Glycated hemoglobin
