论著 Original Article

2型糖尿病男性患者骨代谢指标与骨密度的相关性研究

Published at: 2016年第36卷第12期

袁心露 1 , 杨建军 1 , 朱静宜 1 , 杨培培 1 , 朱晓晖 1 , 崔世维 1
1 南通大学附属医院内分泌科,江苏 南通 226001
通讯作者 世维 崔 Email: 2231726492@qq.com
DOI: 10.3978/j.issn.2095-6959.2016.12.024
基金:
江苏省南通市科技项目课题 MS22015126

摘要

目的:探讨2型糖尿病男性患者骨密度与骨代谢生化指标间的关系。方法:选取我科2014年1月至2015年12月入院的2型糖尿病男性患者102例,采用双能X线骨密度仪,测定腰椎(L2~L4)、股骨上端[包括股骨颈(Neck)、华氏三角(Ward)及股骨粗隆(Troch)]和全身的骨密度(bone mineral density,BMD)值;根据T值将这些患者分为骨量正常组(44例)、骨量减少组(36例)和骨质疏松组(29例),采用酶联免疫法测定各组碱性磷酸酶(alkaline phosphatase,ALP)、N-端中段骨钙素(N-MID-OT)、总Ⅰ型胶原氨基端延长肽(type 1 amino-terminal propeptide,tP1NP)和β胶原特殊序列(β-CTX)的浓度,比较三组骨代谢指标的变化,并对BMD与各项骨代谢指标进行相关性分析。结果:随着骨密度的降低,骨代谢指标的水平逐渐增高,其中,N-MID-OT和β-CTX的水平在三组间的差异皆有统计学意义(P<0.05);tP1NP在骨质疏松组和其余两组有统计学差异(P<0.05);ALP在三组间无统计学差异(P>0.05)。骨量减少组中,N-MID-OT与Neck、Troch及全身的BMD呈负相关(r=−0.754,−0.663,−0.743;P<0.05),β-CTX与Ward的BMD呈负相关(r=−0.273;P<0.05);骨质疏松组中,N-MID-OT与所有部位的BMD呈负相关(r=−0.736,−0.562,−0.715,−0.521,−0.436;P<0.05),β-CTX与Neck、Ward及全身的BMD呈负相关(r=−0.532,−0.614,−0.764;P<0.05)。结论:2型糖尿病男性患者骨密度与骨代谢指标呈负相关,两者联合评估有助于早期预防骨质疏松。


Investigation of the relationship between the bone turnover markers and bone mineral density in male type 2 diabetes patients

Abstract

Objective: To assess the relationship between bone mineral density (BMD) and serum bone turnover markers (BTMs) in male type 2 diabetes mellitus (T2DM) patients. Methods: 102 T2DM men who were hospitalized from January 2014 to December 2015 were enrolled. BMD of the lumbar vertebrae (L2~L4), the proximal femur and the whole body was tested using dual X absorptiometry. All the subjects were divided into 3 groups according to T score. The concentrations of serum N-MID-OT, tP1NP, β-CTX and ALP were examined using ELISA method. The changes of BMD and BTMs among 3 groups were compared and the correlation between BMD and each BTMs was analyzed. Results: BMD of each location in the osteoporotic group was significantly lower than that in the normal bone mass group (P<0.05). The concentrations of N-MID-OT, tP1NP and β-CTX in the osteoporotic group were significantly higher than those in the normal bone mass group (P<0.05). The concentration of N-MID-OT was negatively correlated with BMD of each location and that of β-CTX was negatively correlated with BMD of femoral neck, Troch and whole body in the osteoporotic group (P<0.05). Conclusion: BMD was negatively correlated with BTMs in male T2DM patients and the evaluation of both BMD and BTMs will make contributions to the prevention of osteoporosis at an early stage.


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引用

引用本文: 心露 袁, 建军 杨, 静宜 朱, 培培 杨, 晓晖 朱, 世维 崔. 2型糖尿病男性患者骨代谢指标与骨密度的相关性研究[J]. 临床与病理杂志, 2016, 36(12): 2022-2027.
Cite this article as: YUAN Xinlu, YANG Jianjun, ZHU Jingyi, YANG Peipei, ZHU Xiaohui, CUI Shiwei . Investigation of the relationship between the bone turnover markers and bone mineral density in male type 2 diabetes patients[J]. Journal of Clinical and Pathological Research, 2016, 36(12): 2022-2027.