2型糖尿病合并不同骨量患者外周血Runx2 mRNA表达与25(OH)D的关系  

Relationship between the expression of Runx2 mRNA in peripheral blood and serum 25(OH)D levels in type 2 diabetic patients with various levels of bone mineral density

作　　者：王信[1] 罗丽娅 肖雪[1] 王勇朋[1] 阳琰[1] 王哲 张旋[1] 李琪[1] 樊思桐 朱玉玉 WANG Xin;LUO Liya;XIAO Xue;WANG Yongpeng;YANG Yan;WANG Zhe;ZHANG Xuan;LI Qi;FAN Sitong;ZHU Yuyu(Affiliated Hospital of Zunyi Medical College, Zunyi 563099, China)

机构地区：[1]遵义医学院附属医院,贵州遵义563099

出　　处：《中国骨质疏松杂志》2019年第2期146-151,共6页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金(81460168;37160266);遵义医学院新苗培养及创新探索专项后补助课题(黔科合平台人才[2017]5733-043);遵义市联合基金(遵义科合社字[2018]63)

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并不同骨量患者血浆中转录受体相关转录因子-2 (Runt-related transcription factor-2,Runx2) mRNA表达与25-羟基维生素D[25 hydroxyvitamin D,25(OH)D]的关系。方法选取2016年7月至2017年6月就诊于遵义医学院附属医院骨科和内分泌科住院的初诊2型糖尿病患者150例,根据骨密度结果分为T2DM+骨量正常组(A组)50例、T2DM合并骨量减少组(B组)50例、T2DM合并骨质疏松组(C组)50例。收集同期我院体检中心年龄、性别相匹配的健康体检者为正常对照组(NC组)50名。采用电化学发光法检测血清25(OH)D水平,实时荧光定量聚合酶链反应(Real Time-PCR)检测外周血中Runx2 mRNA的表达水平。结果①A组空腹血浆葡萄糖(fasting plasma ghlcose,FPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(lipoprotein-cholesterol,LDL-C)较NC组明显升高,而HDL-C明显降低(P<0.05);②C组25(OH)D、Runx2 mRNA水平显著低于NC组、A组及B组;B组低于NC组及A组;A组低于NC组,即C组<B组<A组<NC组(P<0.05)。③Pearson相关分析结果示:血浆中25(OH)D与Runx2 mRNA表达呈正相关(r=0.548,P<0.05),与HbAlc、HOMA-IR、TG呈负相关(相关系数r分别为-0.315、-0.323、-0.348,P<0.05)。结论外周血中Runx2 mRNA表达及25(OH)D水平均减低,它们可能共同参与了T2DM、骨质疏松的发生发展。Objective This study aimed to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and runt-related transcription factor-2(Runx2) gene expression in type 2 diabetic patients with various levels of bone mineral density(BMD). Methods A total of 150 patients with type 2 diabetes mellitus(T2 DM) admitted to the department of endocrinology, Affiliated Hospital of Zunyi Medical College between July 2016 and June 2017 were recruited. All patients were divided into three groups according to measurements of BMD: 50 cases in T2 DM with normal BMD group(Group A), 50 cases in T2 DM with osteopenia group(Group B), and 50 cases in T2 DM with osteoporosis group(Group C). Fifty healthy individuals matched for age and gender were recruited from the physical examination center and defined as controls(Group NC). Serum 25(OH)D concentrations in patients were evaluated using electrochemiluminescence immunoassay(ECLIA) and Runx2 gene expression was measured by quantitative real-time PCR(qPCR). Results ECLIA revealed that FPG, HbA1 c, HOMA-IR and LDL-C levels were significantly increased in Group A relative to Group NC, but HDL-C levels were significantly lower(P<0.05). qPCR showed that mRNA expressions of Runx2 were directly proportional to bone mass: Group C < Group B < Group A < Group NC(P<0.05). There was a positive correlation between serum 25(OH)D concentrations and Runx2 mRNA expression using the Pearson correlation coefficient(r=0.548, P<0.05), whereas serum 25(OH)D had a negative correlation with HbA1 c, HOMA-IR, and TG(the r values were-0.315,-0.323, and-0.348, respectively)(P<0.05). Conclusion Our result suggest that both serum 25(OH)D concentrations and Runx2 mRNA expression were reduced in peripheral blood, which may be involved in the development of T2 DM with osteoporosis.

关 键 词：糖尿病 2型 骨量 转录受体相关转录因子-2 25羟维生素D 骨质疏松 

分 类 号：R587.1[医药卫生—内分泌]