2型糖尿病患者血清FGF21、骨连结蛋白和骨转换指标的相关性研究  

Correlation among serum FGF21,osteonectin and bone turnover markers in patients with type 2 diabetes

作　　者：马玉海[1] 陈长松[1] 赵健乐[1] MA Yuhai;CHEN Changsong;ZHAO Jianle(Department of Orthopedics, Zhejiang Provincial Corps Hospital, Hangzhou 310000, China)

机构地区：[1]武警浙江省总队医院骨科,浙江杭州310000

出　　处：《中国骨质疏松杂志》2020年第5期671-675,共5页Chinese Journal of Osteoporosis

摘　　要：目的测量患有2型糖尿病(type 2 diabetes mellitus,T2DM)的早期糖尿病肾病患者的骨转换标志物(bone turnover markers,BTM)水平,并研究BTM与血清成纤维细胞生长因子-21(FGF21)和骨粘连蛋白(OC)的关联。方法纳入患有T2DM的80例男性和150例女性,测量其临床特征、BTM、OC和FGF21水平。结果96例(41.7%)患者出现尿蛋白异常。异常尿蛋白组血清OC(P<0.05)和FGF21(P<0.05)水平明显高于正常尿蛋白组患者。异常尿蛋白组患者血清P1NP水平略低(P<0.05),但调整FBG、PBG和HbA1c后差异消失。血清FGF21水平与eGFR独立且负相关,但与uACR无关。而OC与uACR独立且正相关。血清FGF21水平与P1NP独立地呈负相关。结论持续的高血糖可能会抑制骨形成,OC和FGF21均与T2DM患者的早期肾病相关。Objective The levels of bone turnover markers(BTM)were measured in patients with early diabetic nephropathy from type 2 diabetes mellitus(T2DM),in order to investigate the associations between BTM and serum fibroblast growth factor-21(FGF21)and osteonectin(OC).Methods Eighty males and 150 females with T2DM were included in this cross-sectional study.Clinical characteristics,BTM and adipokine levels were measured.Results Ninety-six(41.7%)patients presented with albuminuria.Patients with albuminuria had significantly higher levels of serum OC(P<0.05)and FGF21(P<0.05)than those with non-albuminuria.Serum levels of P1NP were slightly lower in patients with albuminuria(P<0.05),but the difference disappeared after adjusting for FBG,PBG,and HbA1c.Serum FGF21 levels were independently and negatively correlated to eGFR but not correlated to uACR.OC was independently and positively correlated to uACR.The levels of serum FGF21 were independently negatively related with P1NP.Conclusion Our result suggest that persistent hyperglycemia may inhibit bone formation.Both OC and FGF21 are associated with early nephropathy in T2DM patients.

关 键 词：成纤维细胞生长因子-21 骨粘连蛋白 骨转换指标 糖尿病肾病 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]