初诊2型糖尿病患者餐后骨转换标志物的动态变化  

Dynamic changes in bone turnover markers after intake of food in newly diagnosed type 2 diabetic patients

作　　者：华飞[1] 项守奎[1] 吕欣[1] 万静波[1] 蒋晓红[1] 贾伟平[2] 

机构地区：[1]苏州大学附属第三医院内分泌科,常州213003 [2]上海交通大学附属第六人民医院内分泌代谢科,上海200233

出　　处：《上海交通大学学报（医学版）》2016年第5期712-715,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：常州市科技局项目(CJ20159019)~~

摘　　要：目的探讨初诊2型糖尿病(T2DM)男性患者馒头餐后血清骨转换标志物的动态变化。方法随机选取46例男性初诊T2DM患者(T2DM组)及40例年龄相匹配的体检健康男性(对照组)作为研究对象,所有受试者空腹采静脉血后进食100 g馒头,分别测定空腹及餐后30、60、120及180 min血清1型原胶原N-端前肽(P1NP)及1型胶原交联C-末端肽(β-CTX)等指标,并进行统计学分析。结果空腹状态下,T2DM组的血清P1NP及β-CTX水平均显著低于对照组[P1NP:(40.6±12.9)ng/m L vs(54.2±14.8)ng/m L。β-CTX:(318.6±89.4)pg/m L vs(396.3±105.7)pg/m L。均P<0.05]。与空腹状态下相比,2组餐后各时间点的血清P1NP水平均无显著变化,而血清β-CTX水平随着时间延长显著降低,且均在120 min降至最低,随后略有升高。餐后120 min,T2DM组的血清β-CTX降低率显著低于对照组(34.6%vs 45.2%,P=0.006)。结论初诊T2DM患者的血清骨转换标志物水平显著低于健康人群,并且进食抑制骨吸收的能力也显著降低,这可能是T2DM患者骨折风险增加的原因之一。Objective To investigate the dynamic changes in serum bone turnover markers after intake of steam ed bread in newly diagnosed male type 2 diabetic patients. Methods Forty-six m ale patients with newly diagnosed type 2 diabetes（ T2D M group） and forty healthy m ale individuals with m atched ages（ control group）were enrolled. All participants took 100 g steam ed bread after fasting venous blood was draw n. Fasting procollagen type Ⅰ N-term inal propeptide（ P1 N P） and resorption m arker C-term inal telopeptide of type Ⅰcollagen（ β-C TX） levels and levels of P1 N P and β-C TX 30, 60, 120, and 180 m in after intake of steam ed bread were m easured and statistically analyzed. Results The T2D M group had rem arkably low er fasting serum P1 N P and β-C TX levels as com pared with the control group [P1N P：（ 40. 6 ± 12. 9） vs（ 54. 2 ± 14. 8）ng / m L; β-C TX ：（ 318. 6 ± 89. 4） pg / m L vs（ 396. 3 ± 105. 7） pg / m L. P 〈0. 05 ]. Serum P1 N P levels at time points after intake of steam ed bread in two groups had no significant change as com pared with fasting serum P1 N P levels. However, serum β-C TX levels significantly decreased with tim e, reached troughs at 120 m in, and then increased slightly. The decrease in serum β-C TX in the T2D M group 120 m in after intake of steam ed bread was significantly less than that in the control group（ 34. 6% vs 45. 2%, P = 0. 006）. Conclusion The levels of serum bone turnover m arkers in newly diagnosed T2D M patients are significantly low er as com pared with healthy individuals. The ability of patients to inhibit the bone resorption via intake of food is significantly reduced, which may be one of reasons for the elevated risk of fractures in T2D M patients.

关 键 词：2型糖尿病 馒头餐试验 骨转换标志物 

分 类 号：R587.1[医药卫生—内分泌]