胰高血糖素与骨代谢标志物在2型糖尿病患者中的变化  

Diversification of glucagon and bone metabolic markers in patients with type 2 diabetes mellitus

作　　者：裴晓艳[1] 金国玺[1] 丁波[2] 李冬梅[2] 汪琼[1] PEI Xiao-yan(Department of endocrinology,the first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233004,China.)

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233000 [2]南京医科大学附属南京医院内分泌科,江苏南京210006

出　　处：《齐齐哈尔医学院学报》2020年第9期1064-1067,共4页Journal of Qiqihar Medical University

基　　金：蚌埠医学院科技发展基金项目(BYKF1750);安徽省教育厅重点项目(KJ2019A0353);蚌埠医学院转化医学重点专项项目(BYTM2019039)。

摘　　要：目的 观察胰高血糖素及骨代谢标志物在初发2型糖尿病(T2DM)患者中的变化并探讨其可能的作用机制。 方法 选择2018年3—8月在南京医科大学附属南京医院内分泌科住院的新诊断T2DM患者126例作为研究对象,根据HbA 1c 的水平把患者分为四组,A组:HbA 1c ≤7%,B组:7%<HbA 1c ≤9%,C组:9%<HbA 1c ≤11%,D组:HbA 1c >11%。分别比较各组患者BMI、HbA 1c 、TC、TG、LDL-C、HDL-C、FPG、FINS、FCP、Glu、2hINS、2hCP、2hGlu、OC、P1NP、β-CTX、25(OH)VD、HOMA-IR、HOMA-β的水平,并分析HbA 1c 与各指标的相关性。 结果 四组T2DM患者空腹及餐后胰高血糖素水平随着血糖的升高逐渐升高,D组大于A组( P <0.05),OC、PINP、25(OH)VD逐渐降低,D组均小于A组( P <0.05),而且C组25(OH)VD也小于A组( P <0.05);而β-CTX逐渐升高,D组高于A组( P <0.05)。HbAlc与FPG、HOMA-IR、Glu、2hGlu、β-CTX成正相关( P <0.05),而与FINS、2hINS、FC-P、2hC-P、HOMA-β、OC、PINP、25(OH)VD则呈负相关( P <0.05),与BMI、TC、TG、LDL、HDL无明显相关性( P >0.05)。 结论 初发T2DM患者存在胰高血糖素及骨代谢标志物水平的异常,积极检测其水平,及时了解体内糖代谢与骨代谢异常的状况,可以更好地防治糖尿病性骨质疏松。Objective To observe the changes of glucagon and bone metabolic markers in patients with initial onset T2DM and to explore the possible mechanism.Methods A retrospective analysis was performed on 126 newly diagnosed patients with T2DM who met the inclusion criteria and were admitted to the endocrinology department of Nanjing hospital affiliated to Nanjing Medical University from March to August 2018.Patients were divided into four groups according to the level of HbA 1c:group A:HbA 1c≤7%,group B:7%<HbA 1c≤9%,group C:9%<HbA 1c≤11%,group D:HbA 1c>11%.Levels of BMI、HbA 1c、TC、TG、LDL-C、HDL-C、FPG、FINS、FCP、Glu、2hINS、2hCP、2hGlu、OC、P1NP、β-CTX、25(OH)VD、HOMA-IR、HOMA-βin each group were compared.The correlation between HbA 1c and various indexes was analyzed.Results Fasting and postprandial glucagon levels of T2DM patients in the four groups were gradually increased with the increase of blood glucose,concentration of glucagon in group D was greater than group A(P<0.05).On the contrast,levels of OC、PINP、and 25(OH)VD were gradually reduced as the increase of glucose,and those in group D were lower than group A(P<0.05),and 25(OH)VD in group C was also lower than that in group A(P<0.05).Beta CTX gradually increased,and that in group D was higher than group A(P<0.05).HbAlc was positively correlated with FPG、HOMA-IR、Glu、2hGlu、β-CTX(P<0.05).HbAlc was negatively correlated with FINS、2hINS、FC-P、2hC-P、HOMA-β、OC、PINP、25(OH)VD(P<0.05),and there was no significant correlation with BMI、TC、TG、LDL、HDL(P>0.05).Conclusions Patients with initial T2DM have abnormal levels of glucagon and markers of bone metabolism,which could be actively tested to understand the abnormal status of glucose metabolism and bone metabolism in vivo timely,so as to better prevent and treat diabetic osteoporosis.

关 键 词：2型糖尿病 胰高血糖素 骨代谢标志物 

分 类 号：R587.1[医药卫生—内分泌]