| 叶斌.2型糖尿病患者骨代谢指标与体重指数、胰岛β细胞功能及骨密度相关性研究[J].浙江中西医结合杂志,2018,28(1): |
| 2型糖尿病患者骨代谢指标与体重指数、胰岛β细胞功能及骨密度相关性研究 |
| Relationship of bone metabolic index with body mass index, pancreas βcell function and bone mineral density in patients with type 2 diabetes mellitus |
| 投稿时间：2017-03-14 修订日期：2017-07-12 |
| DOI： |
| 中文关键词: 血Ⅰ型胶原羧基末端肽、骨钙素、骨保护素 稳态模型评估胰岛β细胞功能 骨密度 |
| 英文关键词:C-telopeptide of type 1 collagen(CTX),Osteocalcin(BGP),Aosteoprotegerin (OPG) Homeostasis model assessment(HOMA-β).Bone mineral density(BMD) |
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| 中文摘要: |
| 目的 探讨2型糖尿病（T2DM）患者骨代谢指标与体重指数、胰岛β细胞功能及骨密度相关性。方法 选取120例2013年3月到2015年3月在我科住院T2DM患者，根据2000年WHO亚洲成年人肥胖诊断标准，分为体重肥胖组（OB组）、体重不足组（UW组）、正常组（NW组），另选取118例健康体检人群作为健康对照组（C组）。检测各组血Ⅰ型胶原羧基末端肽（CTX）、骨钙素（BGP）、骨保护素（OPG）、甲状旁腺激素（PTH）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、25羟维生素D3（25-（OH ）D3）、血钙（Ca）、血磷（P），以稳态模型评估胰岛β细胞功能（HOMA-β）。应用双能X线检测腰2椎体（L2）及股骨颈骨密度（BMD）。结果UW及NW组CTX、OPG、FPG、HbA1c均高于C组（P均<0.05），而UW组及NW组BGP、HOMA-β、FINS均低于C组（P均<0.05），OB组FPG、HbA1c均高于C组（P均<0.05）。OB组CTX、OPG、BGP、HOMA-β、FINS与C组比较无明显差异（P>0.05），UW组、NW组及OB组分别与C组比较，年龄、病程、Ca、P无统计学差异（P均>0.05）。UW组及NW组BMD明显低于C组（P均<0.05），OB组的BMD与C组比较无明显差异（P>0.05），进一步相关因素分析显示CTX、OPG与HOMA-β、BMD、BMI均呈负相关（P均<0.05），BGP与HOMA-β、BMD、BMI均呈正相关（P均<0.05）。结论 T2DM患者骨代谢指标CTX、BGP、OPG与骨密度、体重指数、胰岛β细胞功能均密切相关，CTX、BGP、OPG不仅与骨代谢有关，而且可能影响能量代谢与胰岛β细胞功能。 |
| 英文摘要: |
| Objective To investigate the relationship of bone metabolic index with body mass index, pancreas β cell function and bone mineral density in patients with type 2 diabetes mellitus (T2DM).Methods 120 patients with type 2 diabetes mellitus in our department from March 2013 to March 2015 were recruited. They were divided into obesity(OB) group, underweight(UW) group and normal weight(NW) group according to Word Health Organization-Western Pacific Region diagnostic criteria(2000).and another 118 subjects of healthy people were enrolled as healthy control group (group C).Serum C-telopeptide of type 1 collagen(CTX),osteocalcin(BGP),aosteoprotegerin (OPG),parathyroid hormone(PTH),fasting plasma glucose(FPG),glycosylated hemoglobin (HbA1c), fasting insulin (FINS), 25 hydroxyvitamin D3 (25- (OH)D3, calcium ( Ca),and phosphorus (P) were measured.pancreas β-cell function were assessed by homeostasis model assessment(HOMA-β).Bone mineral density(BMD) of lumbar vertebrae (L2) and femoral neck was measured by a dual energy X-ray absorptiometry. Results The levels of CTX, OPG, FPG and HbA1c in UW and NW group were significant higher than those in group C (P <0.05), while the levels of BGP, HOMA-β and FINS in group UW and group NW were significant lower than those in group C (P <0.05).FPG and HbA1c in group OB were significant higher than those in group C (P <0.05). There were no statistical significance in the different levels of CTX, OPG, BGP, HOMA-β , FINS between C group and OB group(P>0.05)and no statistical significance in the difference of age, course of disease, Ca, P (P >0.05). UW group and NW group BMD was significantly lower than that of group C (P <0.05).No significant difference BMD between group C and group OB(P>0.05).Correlation analysis revealed that OPG and CTX was negatively related to HOMA- β, BMD and BMI (P <0.05). BGP was positively related to BMD and HOMA-β. Conclusion Type 2 diabetic patients with bone metabolic markers of CTX, BGP, OPG were not only closely related to BMD,BMI and pancreas β cell function but may also affect energy metabolism and function of islet β cell. |
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