绝经后2型糖尿病患者骨转换标志物与糖化血红蛋白水平的相关性  

Correlation of bone turnover markers and glycosylated hemoglobin in postmenopausal women with type 2 diabetes mellitus

作　　者：张强[1] 王国娟[1] 司玮[1] 孙春萍[1] 刘皆[1] 胡国平[1] 吕芳[1] 马维青[1] 

机构地区：[1]合肥市第一人民医院内分泌科,合肥230061

出　　处：《临床与病理杂志》2017年第12期2571-2575,共5页Journal of Clinical and Pathological Research

基　　金：安徽省公益性研究联动计划(1501ld04065)~~

摘　　要：目的:探讨绝经后2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨转换标志物(bone turnover markers,BTMs)与糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平的关系,分析高血糖对骨代谢的影响。方法:选取2016年1至12月合肥市第一人民医院内分泌科收治的59例绝经后T2DM患者为研究对象,根据HbA1c水平分为A组(HbA1c<9.0%)32例和B组(HbA1c≥9.0%)27例。比较两组间I型前胶原氨基端前肽(procollagen I N-terminal peptide,PINP)、I型胶原蛋白C末端交联肽(type I collagen protein C-terminal crosslinking peptide,CTX)及相关资料的差异,并对BTMs进行相关性分析。结果:B组PINP,CTX水平均低于A组,差异有统计学意义(P=0.022,0.020)。Pearson相关性分析结果显示:PINP与HbA1c呈负相关(r=.0.435,P=0.001)。CTX与TC呈负相关(r=.0.321,P=0.013),与25-羟维生素D(25 hydroxyvitamin D,25-OHD)呈正相关(r=0.278,P=0.033),与HbA1c呈负相关(r=.0.390,P=0.002)。分别以PINP及CTX为因变量,以临床及生化指标为自变量,进行多元线性回归,只有HbA1c进入回归方程,且HbA1c水平越高,PINP及CTX值越低。结论:绝经后T2DM患者随着HbA1c水平增高,骨形成及骨吸收均减少。Objective： To analyze the correlation of bone turnover markers （BTMs） and glycosylated hemoglobin （HbA1c） in postmenopausal women with type 2 diabetes mellitus （T2DM）. Methods： A total of 59 postmenopausal women with T2DM were divided into group A （HbA1c〈9.0%, n=32） and group B （HbA1c≥9.0%, n=27） according to glycosylated hemoglobin level. The differences of procollagen I N-terminal peptide （PINP） and type 1 collagen protein C-terminal crosslinking peptide （CTX） between the two groups were compared, and the correlation analysis of bone turnover markers was carried out. Results： PINP and CTX in group A were lower than those in group B, the difference was statistically significant （P=0.022, 0.020）. Correlation analysis showed that PINP was negatively correlated with HbA1c （r=-0.435, P=0.001）. CTX was negatively correlated with TC （r=-0.321, P=0.013）, positively correlated with 25 hydroxyvitamin D （25-OHD） （r=0.278, P=0.033）, and negatively correlated with HbA1c （r=-0.390, P=0.002）. Multivariate stepwise regression analysis showed that PINP and CTX were all affected by HbA1c. Conclusion： With the increase of HbA1c level, postmenopausal women with T2DM decreased bone formation and bone absorption, and decreased overall bone turnover. By actively controlling blood glucose, it helps maintain bone turnover balance and improves bone quality, thereby reducing the risk of fracture.

关 键 词：2型糖尿病 绝经后 糖化血红蛋白 骨转换标志物 

分 类 号：R580[医药卫生—内分泌] R587.2[医药卫生—内科学]