2型糖尿病患者钙磷代谢与脂肪分布的相关性分析  

A Correlation Analysis Between Calcium and Phosphorus Metabolism and Fat Distribution in Patients with Type 2 Diabetes

作　　者：艾李雅 丁紫菱 吴兴喆 王若梅[1] 代芳[1] AI Liya;DING Ziling;WU Xingzhe;WANG Ruomei;DAI Fang(Department of Endocrinology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院内分泌科,安徽合肥230022

出　　处：《标记免疫分析与临床》2023年第1期42-46,共5页Labeled Immunoassays and Clinical Medicine

基　　金：安徽医科大学基金项目(骨质疏松性骨折和TFG-β的相关研究)(编号:2021xkj060)。

摘　　要：目的探讨2型糖尿病(T2DM)患者腹部脂肪分布与血钙、血磷代谢等指标的相关性。方法选取从2021年9月至2022年4月就诊于安徽医科大学第一附属医院内分泌科的191例甲状旁腺功能正常的T2DM患者的临床资料以及一般实验室检查,通过生物电阻抗技术(BIA)测量患者空腹时的内脏脂肪(VAT)和皮下脂肪(SAT)两者的面积。将内脏脂肪与皮下脂肪的比值(VAT/SAT)以二分位数法分成两组,分别为T1组(VAT/SAT≥0.5)和T2组(VAT/SAT<0.5)。比较两组患者之间的一般临床资料、钙磷代谢相关指标、骨代谢指标、人体成分等相关指标,从而分析之间的相关性。结果与TI组相比,T2组患者的女性比例更高,病程更长,空腹C肽水平、改良的胰岛素抵抗指数(HOMA-islet指数)、三酰甘油水平、尿酸、24h尿磷、全身骨骼肌质量以及四肢骨骼肌质量指数(ASMI)更低;高密度脂蛋白胆固醇水平、24h尿蛋白、血磷水平、钙磷乘积、I型前胶原氨基末端肽水平更高,差异有统计学意义(P<0.05)。多因素Logistic分析提示,在校正性别、病程、三酰甘油、HOMA-Islet等因素后,血磷(OR=15.997,95%CI 1.915~133.628,P=0.010)、钙磷乘积(OR=1.091,95%CI 1.033~1.153,P=0.002)24h尿磷(OR=0.945,95%CI 0.896~0.996,P=0.027)等指标仍与腹部脂肪分布呈独立相关。结论在2型糖尿病患者中,血磷、钙磷乘积、24h尿磷等指标与腹部脂肪分布呈显著相关性,提示2型糖尿病患者的脂肪分布与磷代谢可能存在一定的联系。Objective To explore the correlation between abdominal fat distribution and calcium and phosphorus metabolism in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data and general laboratory tests of 191 T2DM patients with normal parathyroid function who were treated in the Department of Endocrinology,The First Affiliated Hospital of Anhui Medical University from September,2020 to April,2021 were selected for the study.Visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT)were measured by bioelectrical impedance analysis.According to the ratio of visceral fat to subcutaneous fat(vat/sat),all patients were divided into two groups by using the method of binary digits:T1 group(VAT/SAT≥0.5)and T2 group(VAT/SAT<0.5).The general clinical data,calcium and phosphorus metabolism related indicators,bone metabolism indicators,body composition and other related indicators were compared between the two groups,so as to analyze the correlation between the two groups.Results Compared with T1 group,T2 group had a higher proportion of female patients,longer course of disease,lower fasting C-peptide level,homeostasis model assessment-islet(HOMA islet index),triglyceride level,uric acid,24-hour urinary phosphorus,skeletal muscle mass and appendicular skeletal muscle mass index(ASMI);Levels of high-density lipoprotein cholesterol,24-hour urinary protein,blood phosphorus,calcium phosphorus product and amino terminal peptide of type I procollagen were significantly higher in T2 group(P<0.05).Multivariate logistic analysis showed that after adjusting for gender,course of disease,triglyceride,HOMA-islet and other factors,blood phosphorus(OR=15.997,95%CI 1.915-133.628,P=0.010),calcium phosphorus product(OR=1.091,95%CI 1.033-1.153,P=0.002),and 24-hour urinary phosphorus(OR=0.945,95%CI 0.896-0.996,P=0.027)were still independently correlated with the distribution of abdominal fat.Conclusion In patients with type 2 diabetes,serum phosphorus,calcium phosphorus product,and 24-hour urine phosphorus are significantly c

关 键 词：2型糖尿病 钙磷代谢 腹部脂肪分布 

分 类 号：R587.1[医药卫生—内分泌]