2型糖尿病合并骨质疏松患者血清sFRP5和Apelin-13水平与骨代谢标志物的关系  

Correlations of serum sFRP5 and apelin-13 with bone metabolic markers in patients with type 2 diabetes and osteoporosis

作　　者：袁家楠 曹欢 杨慧慧 王丽敏[1] 于璐 汪艳芳 阚全娥 YUAN Jianan;CAO Huan;YANG Huihui;WANG Limin;YU Lu;WANG Yanfang;KAN Quane(Department of Endocrinology,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院河南省人民医院内分泌科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2020年第10期1000-1003,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划省部共建项目(SB201901075)。

摘　　要：目的观察2型糖尿病(type 2 diabetes mellitus, T2DM)合并骨质疏松患者血清分泌型卷曲相关蛋白5(secreted frizzled-related protein 5, sFRP5)、脂肪细胞因子Apelin-13水平变化,探讨其与骨代谢标志物的相关性。方法 T2DM患者170例,根据WHO骨质疏松诊断标准分为骨量正常组60例、骨量减少组60例和骨质疏松组50例。收集患者临床资料,测定空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(glycosylated hemoglobin A1c, HbA1c)、sFRP5、Apelin-13及骨代谢标志物骨钙素N端中分子片段(molecular fragment of osteocalcin N terminal, N-MID)、总Ⅰ型胶原氨基端肽(total procollagen 1 N-terminal peptide, T-P1NP)、1型胶原羧基端肽β特殊序列(β-isomer of C-terminal telopeptide of typeⅠcollagen,β-CTX)和25-羟维生素D3[25 hydroxyvitamin D3, 25(OH)D3]水平,采用Spearman相关分析血清sFRP5、Apelin-13水平与骨代谢标志物的相关性。结果骨质疏松组血清β-CTX[(0.71±0.35)μg/L]和sFRP5[(62.62±10.51)μg/L]水平高于骨量减少组[(0.55±0.29)、(46.91±7.49)μg/L]和骨量正常组[(0.39±0.19)、(38.54±6.94)μg/L](P<0.05),骨量减少组高于骨量正常组(P<0.05);骨质疏松组血清T-P1NP[(23.25±11.86)μg/L]、25(OH)D3[(13.87±3.87)μg/L]、N-MID[(8.08±1.73)μg/L]及Apelin-13[(872.07±85.48)ng/L]水平低于骨量减少组[(29.81±12.97)μg/L、(19.85±7.19)μg/L、(9.97±4.23)μg/L、(1 360.95±176.71)ng/L]和骨量正常组[(35.57±10.04)μg/L、(24.86±8.64)μg/L、(10.69±3.36)μg/L、(1 573.46±67.41)ng/L](P<0.05),骨量减少组血清T-P1NP、25(OH)D3及Apelin-13水平低于骨量正常组(P<0.05),N-MID与骨量正常组比较差异无统计学意义(P>0.05)。血清sFRP5水平与β-CTX呈正相关(r=0.275,P<0.001),与T-P1NP、N-MID、25(OH)D3呈负相关(r=-0.287,P<0.001;r=—0.182,P=0.017;r=-0.369,P<0.001),血清Apelin-13水平与T-P1NP、N-MID、25(OH)D3呈正相关(r=0.405,P<0.001;r=0.300,P<0.001;r=0.508,P<0.001),与β-CTX水平呈负相关(r=-0.200,P=0.009)。结论 T2DMObjective To investigate the changes of serum secreted frizzled-related protein 5(sFRP5)and apelin-13 levels and their correlations with bone metabolic markers in patients with type 2 diabetes mellitus(T2 DM)complicated with osteoporosis(OP).Methods According to WHO diagnostic criteria for OP,170 patients with T2 DM were divided into normal bone mass group(n=60),osteopenia group(n=60)and OP group(n=50).The clinical data of all patients were recorded.The levels of fasting plasma glucose(FPG),glycosylated hemoglobin A1c(HbA1c),sFRP5,apelin-13 and bone metabolic markers including molecular fragment of osteocalcin N terminal(N-MID),total procollagen 1 N-terminal peptide(T-P1 NP),β-isomer of C-terminal telopeptide of type 1 collagen(β-CTX)and 25 hydroxyvitamin D3(25(OH)D3)were determined,and the correlations of sFRP5 and apelin-13 with bone metabolic markers were analyzed by Spearman method.Results The serum levels ofβ-CTX and sFRP5 were significantly higher in OP group((0.71±0.35),(62.62±10.51)μg/L)than those in osteopenia group((0.55±0.29),(46.91±7.49)μg/L)and normal bone mass group((0.39±0.19),(38.54±6.94)μg/L)(P<0.05),and higher in osteopenia group than those in normal bone mass group(P<0.05).The serum levels of T-P1 NP,25(OH)D3,N-MID and apelin-13 were lower in OP group((23.25±11.86)μg/L,(13.87±3.87)μg/L),((8.08±1.73)μg/L,(872.07±85.48)ng/L)than those in osteopenia group((29.81±12.97)μg/L,(19.85±7.19)μg/L,(9.97±4.23)μg/L,(1360.95±176.71)ng/L)and normal bone mass group((35.57±10.04)μg/L,(24.86±8.64)μg/L,(10.69±3.36)μg/L,(1573.46±67.41)ng/L)(P<0.05),the levels of T-P1 NP,25(OH)D3 and apelin-13 were lower in osteopenia group than those in normal bone mass group(P<0.05),and N-NID level showed no significant difference between osteopenia group and normal bone mass group(P>0.05).The serum sFRP5 level was positively correlated withβ-CTX(r=0.275,P<0.001)and negatively correlated with T-P1 NP(r=-0.287,P<0.001),N-MID(r=-0.182,P=0.017)and 25(OH)D3(r=-0.369,P<0.001).The serum apelin-13 level

关 键 词：2型糖尿病 骨质疏松 分泌型卷曲相关蛋白5 脂肪细胞因子Apelin-13 骨代谢标志物 

分 类 号：R587.2[医药卫生—内分泌] R580[医药卫生—内科学]