中老年男性2型糖尿病合并代谢综合征对骨代谢的影响  

The effect of type 2 diabetes mellitus with metabolic syndrome on bone metabolism in middle-aged and elderly men

作　　者：王星[1] 赵锦程[2] 范冬梅[1] 刘俊茹[1] 尹福在[1] WANG Xing;ZHAO Jin-cheng;FAN Dong-mei(Department of Endocrinology of the First Hospital of Qinhuangdao Qinhuangdao 066000,China;Department of Neurosurgery of the First Hospital of Qinhuangdao,Qinh uangdao 066000,China)

机构地区：[1]秦皇岛市第一医院内分泌二科,河北秦皇岛066000 [2]秦皇岛市第一医院神经外二科,河北秦皇岛066000

出　　处：《中国实验诊断学》2020年第8期1269-1272,共4页Chinese Journal of Laboratory Diagnosis

基　　金：河北省卫计委2019年度医学科学研究重点课题计划20191377。

摘　　要：目的探讨中老年男性2型糖尿病合并代谢综合征(MS)对骨代谢的影响。方法选取中老年男性2型糖尿病患者203人,分为非代谢综合征组(非MS组)和代谢综合征组(MS组),测定各组的身体质量指数(BMI)、腰围(WC)、收缩压(SDP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、骨钙素(OC)、Ⅰ型前胶原氨基末端前肽(P1NP)、I型胶原交联C-末端肽(CTX)和骨密度(BMD)。结果MS组的P1NP、OC明显低于非MS组(P<0.001),CTX明显高于非MS组(P<0.001)。MS组股骨干、全髋、L1、L2、L3、L4的BMD值高于非MS组(P<0.05)。相关分析显示:MS组中,OC与P1NP正相关(r=0.415,P<0.001),与CTX(r=-0.282,P=0.002)、BMI(r=-0.361,P<0.001)、HbA1c(r=-0.473,P<0.001)、WC(r=-0.304,P=0.001)成负相关;P1NP与CTX(r=-0.251,P=0.005)、BMI(r=-0.297,P=0.001)、HbA1c(r=-0.268,P=0.003)、WC(r=-0.266,P=0.003)负相关;CTX与BMI(r=0.230,P=0.011)、HbA1c(r=0.394,P<0.001)、WC(R=0.199,P=0.029)正相关。多元线性回归分析显示:MS组中BMI和HbA1c是骨代谢指标OC、P1NP和CTX的独立危险因素。结论中老年男性2型糖尿病合并代谢综合征状态下随BMI增加骨量增加,与骨代谢指标变化趋势不一致,BMI和HbA1c是影响骨代谢指标的独立危险因素。Objective To investigate the effect of type 2 diabetes mellitus with metabolic syndrome on bone metabolism in middle-aged and elderly men.Methods 203 middle-aged and elderly male patients with type 2 diabetes were recruited and divided into non-metabolic syndrome group(non-MS group)and metabolic syndrome group(MS group).Anthropometric measurements include BMI,WC,SDP,DBP,HbA1 c,FPG,TG,HDL-c,OC,P1 NP,CTX,BMD.Results1.P1 NP and OC in MS group were significantly decreased than in non-MS group(P<0.001),while CTX in MS group was significantly higher than in non-MS group(P<0.001).BMD of Femoral,Total hip,L1,L2,L3,L4 in MS group were higher than in non MS group(P<0.05).2.In MS group,OC was positive correlated with P1 NP(R=0.415,P<0.001).was negatively correlated with CTX(R=-0.282,P=0.002),BMI(R=-0.361,P<0.001),HbA1 c(R=-0.473,P<0.001),WC(R=-0.304,P=0.001).P1 NP was negatively correlated with CTX(R=-0.251,P=0.005),BMI(R=-0.297,P=0.001),HbA1 c(R=-0.268,P=0.003),WC(R=-0.266,P=0.003).CTX was positive correlated with BMI(R=0.230,P=0.011),HbA1 c(R=0.394,P<0.001),WC(R=0.199,P=0.029).3.Multivariate linear regression analysis sugested:In the MS group,BMI and HbA1 cwere independent risk factors for bone metabolism index such as OC,P1 NP and CTX.Conclusion in type 2 diabetes mellitus with metabolic syndrome middle-aged and elderly men,bone mass increased with BMI,which was inconsistent with the change of bone metabolism index.BMI and HbA1 cwere independent risk factors for bone metabolism indicators index.

关 键 词：中老年 男性 2型糖尿病 代谢综合征(MS) 骨钙素(OC) 

分 类 号：R587.1[医药卫生—内分泌]