男性血清骨钙素水平与糖尿病性周围神经病变的相关性研究  

Serum osteocalcin and diabetic peripheral neuropathy in male patients with diabetes

作　　者：何泱 赵琳 杨心瑜 卞华 He Yang;Zhao Lin;Yang Xinyu;Bian Hua(Department of Endocrinology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院内分泌科,上海200032

出　　处：《中华内分泌代谢杂志》2022年第6期503-508,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然基金青年项目(82100827);上海市青年科技英才扬帆计划(19YF1430000)。

摘　　要：目的探讨血清骨转换指标骨钙素水平对男性糖尿病性远端对称性多发性神经病变(DSPN)的影响。方法收集2020年1月至2021年11月复旦大学附属中山医院诊治的370例男性糖尿病患者的临床资料, 根据其血清骨钙素三分位水平将患者分为T1组(骨钙素<9.2 ng/mL, 123例)、T2组(骨钙素9.2~13 ng/mL, 122例)、T3组(骨钙素≥13 ng/mL, 125例), 比较3组间DSPN所占比例, 多元logistic回归计算不同组DSPN的发生风险。结果血清骨钙素T1、T2、T3组合并DSPN者分别为50例(40.7%)、29例(23.8%)、49例(39.2%), 骨钙素T2组DSPN合并率显著低于T1和T3组;在调整了年龄、糖尿病病程、HbA1C、糖尿病合并症、Ⅰ型胶原羧基端肽β交联肽(CTXβ)、血25-羟维生素D(25-OHD)、骨密度、治疗药物等多项混杂因素后, 相对于骨钙素T2组, T1、T3组DSPN风险分别增加133.9%(OR=2.339, 95%CI 1.097~4.988,P=0.028)和134.2%(OR=2.342, 95%CI 1.040~5.275,P=0.039)。结论男性糖尿病患者骨转换指标骨钙素水平和DSPN相关, 中等程度的骨转换水平(例如血清骨钙素水平维持在9.2~13 ng/mL)可能对DSPN有保护作用。Objective To investigate the association between serum bone turnover marker osteocalcin and the distal symmetric poly neuropathy(DSPN)in male diabetic patients.Methods Clinical data from 370 male diabetic patients who admitted to Zhongshan Hospital,Fudan University from January 2020 to November 2021 were collected.These patients were grouped into tertiles by serum osteocalcin level:T1 group(osteocalcin<9.2 ng/mL,n=123),T2 group(osteocalcin 9.2-13 ng/mL,n=122),and T3 group(osteocalcin≥13 ng/mL,n=125).The percentage ratios of DSPN were compared among these groups.Using logistic regression model,the adjusted odds ratio(OR)for DSPN was calculated.Results There were 50(40.7%),29(23.8%),49(39.2%)patients with DSPN in T1,T2,and T3 group respectively.The ratio of patients with DSPN in osteocalcin T2 group were lower than that in the T1 and T3 groups.Further logistic regression showed a 133.9%(OR=2.339,95%CI 1.097-4.988,P=0.028)and a 134.2%(OR=2.342,95%CI 1.040-5.275,P=0.039)increased risk for DSPN in the T1 and T3 group respectively compared with the T2 group,even after adjusted for age,diabetic duration,HbA1C,diabetic complications,βcross-linked C-telopeptide of typeⅠcollagen(CTXβ),25-hydoxy vitamin D(25-OHD),bone mineral density,and treatment.Conclusions The serum levels of bone turnover marker osteocalcin were associated with the occurrence of DSPN in male diabetic patients,a moderate level of bone turnover(the serum osteocalcin level of between 9.2 and 13 ng/mL for instance)might be protective for male diabetic patients from DSPN.

关 键 词：糖尿病性周围神经病变 骨钙素 骨转换 

分 类 号：R587.2[医药卫生—内分泌]