2型糖尿病视网膜病变与骨生化标志物的相关性分析  

Correlation between type 2 diabetic retinopathy and bone biochemical markers

作　　者：娄阳 徐进[1] 于智超 LOU Yang;XU Jin;YU Zhichao(Department of Endocrinology,Shandong Provincial Hospital affiliated to Shandong University,Jinan 250000,China)

机构地区：[1]山东大学附属省立医院内分泌科,山东济南250000

出　　处：《中国骨质疏松杂志》2018年第11期1476-1479,1497,共5页Chinese Journal of Osteoporosis

基　　金：山东省重点研发计划(2016GSF201025;2016GGH3118)

摘　　要：目的对2型糖尿病(type 2 diabetes mellitus,T2DM)绝经后女性骨代谢生化标志物与视网膜病变程度之间的关系进行探讨,并分析其相关因素。方法回顾性分析178例绝经后2型糖尿病女性患者视网膜病变程度与骨代谢生化标志物的相关性并探讨其可能机制。结果视网膜病变程度与年龄、体质指数(body mass index,BMI)、甲状旁腺素(parathyroid hormone,PTH)、骨钙素N端中分子片段(N-MID osteocalcin,N-MIDoc)、血钙(Ca)、血磷(P)、钙磷乘积(Ca×P)、糖化血红蛋白(hemoglobin A1C,HbA1C)无明显相关性;随着视网膜病变程度的进展,病程、I型胶原交联C-末端Beta特殊序列(β-carboxyl terminal peptide,β-CTX)、总I型原胶原N端前肽(total type I procollagen N-terminal propeptide,T-PINP)成上升趋势,C肽、25-羟基维生素D(25-hydroxy vitamin D,VitD-T)、右前臂骨密度(bone mineral density,BMD)、T值成逐渐下降趋势,且组间差异有统计学意义(P<0.05)。Spearman相关分析示病程与右前臂BMD及T值呈负相关,C肽与ViTD-T呈正相关,HbA1C与PTH、N-MIDoc、T-PINP呈负相关。结论 2型糖尿病绝经后女性患者骨代谢生化标志物与视网膜病变程度呈明显相关趋势,表明糖尿病骨病很可能是糖尿病微血管病变的另一种表现形式。Objective To investigate the relationship between bone metabolic markers and degree of retinopathy in postmenopausal women with type 2 diabetes mellitus, and to analyze the related factors. Methods The correlation between the degree of retinopathy and the biochemical markers of bone metabolism in 178 postmenopausal women with type 2 diabetes was retrospectively analyzed, and the possible mechanism was discussed. Results The degree of retinopathy was not significantly correlated with age, BMI, PTH, N-MIDoc, Ca, P, Ca×P, and HbA1C. With the progression of retinopathy, the course of disease, β-CTX, and T-PINP became upward trend, and C peptide, VitD-T, BMD of the right forearm, T score decreased gradually, with significant differences among the groups (P<0.05). Spearman correlation analysis showed that the course of disease was negatively correlated with BMD and T values of the right forearm, C-peptide was positively correlated with ViTD-T, and HbA1C was negatively correlated with PTH, N-MIDoc and T-PINP. Conclusion The biochemical markers of bone metabolism in postmenopausal women with type 2 diabetes have a significant correlation with the degree of retinopathy, indicating that diabetic osteopathy is another form of diabetic microvascular disease.

关 键 词：微血管病变 骨质疏松 骨代谢生化标志物 

分 类 号：R68[医药卫生—骨科学]