2型糖尿病性骨质疏松与GH/IGF-1轴的关系研究  

Study on relationship of type 2 diabetic osteoporosis and GH/IGF-1 axis

作　　者：邓智勇[1] 张玫[1] 田慧[1] 伍援朝[2] 周君[1] 黄亨建[1] 

机构地区：[1]四川大学华西医院实验医学科,四川成都610041 [2]四川大学华西医院骨密度室,四川成都610041

出　　处：《现代预防医学》2014年第13期2479-2481,2496,共4页Modern Preventive Medicine

基　　金：四川省科技厅科技支撑项目(2013FZ0011)

摘　　要：目的探讨2型糖尿病性骨质疏松与GH/IGF-1平衡的关系。方法纳入54例T2DM患者(其中合并骨质疏松(DO)患者27例,无骨质疏松的患者(DM)27例),正常对照30例,收集受试者一般资料,并采集空腹血检测生长激素(GH)、I型胶原交联C-末端肽(CTX)、I型原胶原N端前肽(PINP)、骨钙素(OT)、胰岛素样生长因子(IGF-1)、钙(Ca)、磷(P)。结果 (1)OP组BMI低于DM组和对照组,3组之间两两比较,差异有统计学意义(P<0.05)。DO组GH较DM组和对照组高(P<0.05),IGF-1水平在DO组有低于DM组趋势,DM组有低于正常对照组趋势,但差异无统计学意义,GH/IGF-1 3组间两两比较差异有统计学意义。DO组PINP、OT、CTX水平有高于DM组和对照组的趋势,但差异无统计学意义。Ca、P 3组差异无统计学意义。(2)CTX(r=-0.335,P<0.05)与PINP(r=-0.373,P<0.05)均与病程呈负相关。IGF-1与PINP(r=0.238,P<0.05)、OT(r=0.636,P<0.05)呈正相关。GH与BMI(r=-0.295,P<0.05)呈负相关。GH/IGF-1与腰椎T值(r=-0.245,P<0.05)、股骨T值(r=-0.232,P<0.05)呈负相关,与BMI呈负相关(r=0.264,P<0.05)。结论GH/IGF-1轴可能参与了2型糖尿病骨质疏松的发生发展。Objective To investigate the relationship of type 2 diabetic osteoporosis and GH/IGF-1 axis. Methods A total of 54subjects were included, in which 27 diabetic patients combined with osteoporosis（DO）, 27 diabetic patients without osteoporosis（DM）, 30 healthy controls. Collected general information of all subjects and detected serum growth hormone（GH）, I collagen cross-linked C-telopeptide（CTX）, I procollagen N-terminal propeptide（PINP）, osteocalcin（OT）, insulin-like growth factor（IGF-1）, calcium（Ca）, phosphorus（P）. Results（1） The BMI was lower in the DO group than the DM group and control group（P〈0.05）. GH levels were higher in the DO group than the DM group and control group（P〈0.05）, IGF-1 levels in the DO group trended to decrease comparing with DM group and control group, but the difference was not statistically significant, GH/IGF-1 were higher in the DO group than the DM group（P〈0.05）, and in the DM group was higher in the control group（P〈0.05）. PINP, OT, CTX levels in the DO group were higher than the DM group and the control group, but the difference was no statistically significant. Ca, P levels were not significantly different among the three groups.（2） CTX（r=-0.335, P〈0.05） and PINP（r=-0.373, P〈0.05） were negatively correlated with disease duration. IGF-1 was positively correlated with PINP（r=0.238, P〈0.05） and OT（r=0.636, P〈0.05）. GH was negatively correlated with BMI（r=-0.295, P〈0.05）. GH/IGF-1 were negatively correlated with lumbar spine T-score（r=-0.245,P〈0.05）, femur T-score（r=-0.232, P〈0.05）, and BMI（r=0.264, P〈0.05）. Conclusion GH/IGF-1 axis may be involved in the development of type 2 diabetic osteoporosis.

关 键 词：2型糖尿病性骨质疏松 生长激素 胰岛素样生长因子 

分 类 号：R181.38[医药卫生—流行病学]