河南省成年男性骨转换标志物水平及与代谢综合征的相关性分析  

Association between bone turnover markers and metabolic syndrome among men in Henan Province

作　　者：王娇[1] 马晓君[1] 刘彦玲 赵艳艳[1] 李志臻[1] 郭丰[1] 吴丽娜[1] 马笑堃[1] 秦贵军[1] 滕卫平[2] Wang Jiao;Ma Xiaojun;Liu Yanling;Zhao Yanyan;Li Zhizhen;Guo Feng;Wu Lina;Ma Xiaokun;Qin Guijun;Teng Weiping(Department of Endocrinology and Metabolism,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Internal Medicine,The First Affiliated Hospital of China Medical University,Shenyang 101100,China)

机构地区：[1]郑州大学第一附属医院内分泌与代谢病科,450052 [2]中国医科大学附属第一医院内分泌与代谢病科,沈阳101100

出　　处：《中华糖尿病杂志》2020年第1期35-40,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：河南省科技攻关项目(192102310064);国家自然科学基金青年基金(81500646);中华医学会临床医学科研专项资金(15010010589)。

摘　　要：目的探讨河南省不同年龄段成年男性血清骨转换标志物水平及与代谢综合征(MS)的相关性。方法2015年12月至2016年3月,采用多阶段分层整群随机抽样法从甲状腺疾病和糖尿病全国调查-2014研究——河南分中心调查队列中抽取697例男性受试者,所有受试者填写调查问卷,测量身高、体重、腰围和血压,行口服葡萄糖耐量试验,抽空腹静脉血测定糖化血红蛋白、总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、骨钙素、Ⅰ型前胶原氨基端前肽(PⅠNP)、β-Ⅰ型胶原交联羧基末端肽(β-CTX)、25羟维生素D[25(OH)D]和甲状旁腺素(PTH)水平。采用Spearman相关分析和二分类Logistic回归分析探讨骨转换标志物与MS及其各组分的相关性。结果本研究最终纳入697名男性受试者,年龄(46.6±15.9)岁。体质指数(BMI)17.1~39.0 kg/m^2,平均(25.97±3.69)kg/m^2。校正年龄、PTH、25(OH)D、骨钙素、PⅠNP、β-CTX和吸烟后,BMI仍是MS的危险因素(OR=1.263,95%CI 1.198~1.332)。Spearman相关分析结果显示,骨钙素、PⅠNP与MS呈明显负相关(r=-0.154、-0.107,均P<0.01),β-CTX与MS无明显相关性。二分类Logistic回归分析结果显示,骨钙素是MS、腹型肥胖、高血糖、高血压及高TG的保护因素,校正了年龄、PTH、25(OH)D和BMI后,骨钙素仍是高血糖(OR=0.971,95%CI 0.947~0.995)和高TG(OR=0.955,95%CI 0.931~0.980)的保护因素;再进一步校正吸烟,结果无明显变化。PⅠNP是MS、腹型肥胖、高血糖和高血压的保护因素;校正了年龄、PTH和25(OH)D后,PⅠNP仍是腹型肥胖(OR=0.993,95%CI 0.988~0.999)的保护因素;进一步校正BMI和吸烟后,PⅠNP与MS及MS各组分无明显相关性。结论体重控制对于预防成年男性MS至关重要,较高水平的骨钙素和PⅠNP可能有助于预防和延缓MS。Objective To assess associations of bone turnover markers with metabolic syndrome(MS)among men in Henan Province.Methods From December 2015 to March 2016,a total of 697 male subjects were selected from the TIDE(Thyroid Disorders,lodine status and Diabetes:a National Epidemiological Survey-2014)research--Henan sub-center survey using multistage stratified cluster random sampling.All included subjects received standard oral glucose tolerance test,a physical examination(height,weight,waist circumference and blood pressure),a collection of blood samples to determine the level of plasma glucose,glycated hemoglobin A1c,total cholesterol,triglyceride(TG),high-density lipoprotein-cholesterol,low-density lipoprotein-cholesterol,osteocalcin,pro-collagen type 1 N-terminal propeptide(PⅠNP),C-terminal-cross-linking telopeptide of type 1 collagen(β-CTX),25-hydroxyvitamin D[25(OH)D]and parathyroid hormone(PTH),and all of them completed the questionnaire.The associations between bone turnover markers and MS were analyzed using Spearman correlation and binary logistic regression,respectively.Results A total of 697 men with an age of(46.6±15.9)years were included in the study.The average body mass index(BMI)was(25.97±3.69)kg/m^2(17.1-39.0 kg/m^2).After adjusted for age,PTH,25(OH)D,BMI and smoke,BMI was found as a risk factor for MS(OR=1.263,95%CI 1.198-1.332).Spearman correlation analysis showed that OC and PⅠNP was negatively associated with MS(r=-0.154,-0.107,both P<0.01),but there was no significant correlation betweenβ-CTX and MS.The results of the binary logistic regression analysis showed that OC was a protective factor for MS,abdominal obesity,hyperglycemia,hypertension and high TG;after adjusted for age,PTH,25(OH)D and BMI,osteocalcin was also a protective factor for hyperglycemia(OR=0.971,95%CI 0.947-0.995)and high TG(OR=0.955,95%CI 0.931-0.980);further adjusted for smoke,the results were same as before.PⅠNP was a protective factor for MS,abdominal obesity,hyperglycemia and hypertension;after adjusted for age,PT

关 键 词：骨钙素 Ⅰ型前胶原氨基端前肽 β-Ⅰ型胶原交联羧基末端肽 代谢综合征 男性 

分 类 号：R589[医药卫生—内分泌]