骨钙素与成人1型糖尿病患者糖代谢调节的相关性研究  

Association between osteocalcin and regulation of glucose metabolism in adult type 1 diabetes mellitus

作　　者：李晶晶 陆婧[1] 毕艳[1] 李想[2] 凌清 朱大龙[1] Li Jingjing;Lu Jing;Bi Yan(Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School , Nanjing 210000, China)

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,南京210000 [2]中国医学科学院北京协和医学院

出　　处：《临床内科杂志》2018年第5期333-336,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨成人1型糖尿病（T1DM）患者的骨钙素水平及其在T1DM糖代谢调节中的作用。方法纳入T1DM患者105例（T1DM组）及同期性别、年龄相匹配的非糖尿病住院患者92例（对照组），收集其一般资料及相关实验室检查指标，并进行比较分析。结果T1DM组的骨钙素水平较对照组明显降低（P〈0．05）。骨钙素与糖化血红蛋白（HbA1c）呈负相关（P：0．002），与碱性磷酸酶（ALP）、血磷、甲状旁腺激素（丌H）、1型胶原羧基端肽B特殊序列（β-CTX）、1型胶原氨基端延长肽（P1NP）呈正相关（P〈0．05），与血钙、降钙素、25羟维生素D3[25（OH）D3]均无明显相关性（P〉0．05）。多元线性回归分析结果显示，骨钙素是影响T1DM组患者HbA1c的独立保护因素（P=0．024），骨钙素水平每升高1ng／ml，HbA1c下降0．18％。根据骨钙素水平对T1DM患者进行亚组分析结果显示，高骨钙素组的HbA1c水平更低（P〈0．05），空腹C肽更高（P〈0．05）。结论T1DM患者的骨钙素水平较非糖尿病患者明显降低，骨钙素水平越高提示血糖控制及胰岛功能相对更好，骨钙素可能参与了T1DM的糖代谢调节。Objective To investigate the level of osteocalcin in adult type 1 diabetes mellitus （T1DM） and its role in the regulation of glucose metabolism. Methods A total of 105 T1DM patients （T1DM group） and 92 non-diabetic hospitalized patients （control group） were included. The general data and laboratory measurements were collected and analyzed. Results T1DM group showed significantly decreased level of osteoealcin compared to control group（ P 〈 0.05 ）. Osteocalein was negatively related to glyeosylated hemoglobin （HbAlc, P = 0. 002 ）, while positively associated with alkaline phosphatase （ ALP ） , serum phosphorus, parathyroid hormone （ PTH ）, β-C-terminal telopeptide of type I collagen （I3-CTX） and procollagen type 1 N-terminal propeptide （P1NP）. Osteocalein was not related to serum calcium, serum calcitonin and 25 hydroxy-vitamin D3 [ 25 （ OH ） D3 ] （ P 〉 0. 05 ）. Muhivariate linear regression analysis revealed that osteocalein was an independent protective factor for HbA1c （P = 0.024 ）. For every 1 ng/ml increase of osteocalcin, HbAlc decreased by 0.18%. Subgroup analysis based on the level of osteocalcin in T1DM patients showed that patients with higher osteocalcin had significantly lower HbA1c （ P 〈 0.05 ） and higher fasting C peptide （ P 〈 0.05 ）. Conclusion The level of osteoealcin decreases significantly in T1DM patients. Higher osteocalcin in T1DM is associated with better glycemia and islet function, indicating the involvement of osteoealcin in the regulation of glucose metabolism in T1 DM patients.

关 键 词：骨钙素 糖代谢 1型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]