摘要
目的:探讨老年男性2型糖尿病骨转换指标血清骨钙素(osteocalcin,OC)、Ⅰ型胶原C-末端肽(serum cross-linked C-terminal telopeptides of type I collagen,sCTX)与骨密度和骨质疏松风险的关系.方法:入选228名老年男性2型糖尿病(年龄60~95岁),测定空腹血清OC、sCTX的浓度,以及腰椎、左侧髋部的骨密度.按照WHO骨质疏松诊断标准将这些患者分为骨量正常组(76例)、低骨量组(100例)和骨质疏松组(52例),比较三组患者的一般资料和血清OC、sCTX浓度及各部位骨密度值的差异.分别分析血清OC、sCTX浓度与各部位的骨密度及骨质疏松风险的关系.结果:骨质疏松组患者的血清OC和sCTX的浓度较骨量正常组、低骨量组均显著升高.血清OC、血清sCTX与各部位骨密度均成显著负相关,校正年龄与体重指数后,OC、sCTX与各部位骨密度仍呈负相关.分别按血清OC和sCTX的四分位数分组,随四分位数增加,各部位骨密度减低.分别以OC、sCTX水平最高的四分组为病例组,水平最低的组为对照组计算骨质疏松风险比值比.腰椎的骨质疏松风险显著增加4.80倍(CI :1.64~14.06),6.12倍(CI :1.92~19.50).以OC水平最高的四分组为病例组,水平最低的组为对照组,股骨颈的骨质疏松风险增加5.16倍(CI :1.06~25.04).结论:老年男性2型糖尿病血清OC和sCTX均与骨密度呈负相关,血清OC和sCTX显著增加者腰椎骨质疏松风险增加,血清OC显著增加者股骨颈骨质疏松风险增加.
Objective To investigate the relationship between serum bone turnover markers (BTM), including osteocalcin (OC), and cross-linked C-terminal telopeptides of type I collagen (CTX), and bone mineral density (BMD) and risk of osteoporosis in type 2 diabetic old men. Methods A cross-sectional study 228 type 2 diabetic old men aged 60 - 95 years was conducted. The levels of serum OC, sCTX were assessed. BMD at the lumbar spine and the left hip was measured using DXA. According to WHO definitions, these patients were grouped into three groups, normal hone mass group (n=76), osteopenia group (n=100), osteoporosis group (n=52). The mean values of different parameters from the three groups were compared with each other for significant differences with one-way ANOVA analysis. The correlations between BTMs and BMD were made using Pearson's correlation and a partial correlation analysis after adjustment for age and BMI. All subjects were stratified by OC and sCTX quartiles (QI?Q4), respectively. The x^2 test was used to compare the risk of osteoporosis in different quartiles groups. Odd ratios were calculated by comparing the highest quartile of OC and sCTX (Q4, case group) and the lowest (Q1, control groups). Results The serum levels of OC and sCTX in osteoporosis group were higher than those in normal bone mass group and osteopenia group, respectively. Correlation analyses showed significant negative correlations between BTM and BMD at different skeletal sites. After adjustment for age and Body mass index, the partial correlation coefficients between semm OC and sCTX and BMD at various skeletal sites were still significant. The risk of osteoporosis at lumbar spine in the Q4 group of OC and sCTX were 4.80 times (CI: 1.64-14.06) and 6.12 times (CI: 1.92-19.50), respectively. The risk of osteoporosis at femoral neck in the Q4 group of OC was 5.16 times (CI: 1.06-25.04). Conclusions The levels of serum OC and sCTX were negative correlated with BMD. The risk of osteoporosis at lumbar spine increased with significantly increase
作者
皮银珍
李琳
王环君
高海花
陈娟
陈少波
杨新艳
Pi Yin-zhen;Li Lin;Wang Huan-jun;Gao Hai-hua;Chen Juan;Chen Shao-bo(Department of Endocrinology and Metabolism,The First Hospital of Changsha,Changsha 410005,China)
出处
《湖南师范大学学报（医学版）》
2019年第5期3-7,共5页
Journal of Hunan Normal University(Medical Sciences)
基金
湖南省卫生健康委科研项目（B2017230）
关键词
骨转换指标
骨密度
骨质疏松风险
2型糖尿病
老年男性
bone turnover marker
bone mineral density
osteoporotic risk
type 2 diabetes mellitus
old men
