不同阶段糖尿病肾病患者血清25-OH-D3、BMP2、RBP4及超声骨密度测定与分析  

Determination and analysis of serum 25-OH-D3,BMP2,RBP4 and ultrasound bone mineral density in patients with different stages of diabetic nephropathy

作　　者：王昭 韩璐璐 马静静[2] 宋宁宁 姚明言[2] 王生海 李志红[2] 郭畑灿 宋茜茜 WANG Zhao;HAN Lu-lu;MA Jing-jing(Department of Outpatient,Baoding First Central Hospital,Baoding Hebei 071000,China;Department of Endocrinology,Baoding First Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院门诊部,河北保定071000 [2]保定市第一中心医院内分泌科,河北保定071000 [3]保定市第一中心医院泌尿外科,河北保定071000 [4]河北大学附属医院重症医学科,河北保定071000 [5]保定市第一中医院康复医学科,河北保定071000

出　　处：《临床和实验医学杂志》2023年第4期368-371,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学适用技术追踪项目(编号:GZ2021055);保定市科技计划项目(编号:224ZF067)。

摘　　要：目的分析不同阶段糖尿病肾病(DN)患者血清25-羟维生素D3(25-OH-D3)、骨形态发生蛋白2(BMP2)、视黄醇结合蛋白4(RBP4)、超声骨密度的变化。方法回顾性选取2020年1月至2022年1月保定市第一中心医院收治的40例单纯糖尿病患者为A组,40例DN微量尿蛋白患者为B组,40例DN大量尿蛋白患者为C组,40例正常体检者为对照组,比较4组骨代谢指标[总I型胶原氨基端延长肽(PINP)、β-I型胶原羧基端肽(β-CTX)]、骨密度指标(股骨近端骨密度)、血清25-OH-D3、BMP2、RBP4水平,并分析血清25-OH-D3、BMP2、RBP4与骨代谢指标、骨密度指标相关性。结果C组PINP水平为(24.53±6.02)μg/L,低于B组、A组、对照组[(28.97±5.11)、(32.59±5.81)、(33.54±5.46)μg/L],β-CTX水平为(420.15±42.86)μg/L,高于B组、A组、对照组[(387.65±49.87)、(326.87±42.07)、(336.58±36.15)μg/L],差异均有统计学意义(P<0.05);C组股骨近端骨密度为(0.71±0.11)g/cm2,低于B组、A组、对照组[(0.86±0.17)、(0.88±0.21)、(0.90±0.18)g/cm2],差异有统计学意义(P<0.05)。C组25-OH-D3、RBP4水平分别为(7.26±2.09)、(4.92±1.33)μg/L,低于B组[(12.38±2.84)、(7.42±2.21)μg/L]、A组[(12.99±3.01)、(7.67±2.06)μg/L]、对照组[(10.36±2.47)、(5.97±1.59)μg/L],BMP2水平为(40.07±5.81)μg/L、高于B组、A组、对照组[(37.11±5.29)、(34.05±6.27)、(33.25±6.14)μg/L],差异均有统计学意义(P<0.05)。Pearson相关分析,25-OH-D3、RBP4与PINP、股骨近端骨密度呈正相关(P<0.05),与β-CTX呈负相关(P<0.05);BMP2与PINP、股骨近端骨密度呈负相关(P<0.05),与β-CTX呈正相关(P<0.05)。结论DN患者随病情进展,骨量丢失增加,骨密度下降,血清25-OH-D3、BMP2、RBP4水平与骨密度、骨代谢有关,早期通过测定以上因子水平可敏感反映DN患者骨质变化,以便对骨质疏松尽早预防和诊疗。Objective To analyze the serum 25-hydroxyvitamin D3(25-OH-D3),bone morphogenetic protein 2(BMP2),retinol binding protein 4(RBP4),and Changes in bone mineral density on ultrasound.Methods A total of 40 patients with simple diabetes mellitus admitted to Baoding First Central Hospital from January 2020 to January 2022 were selected as group A,and 40 patients with DN microproteinuria were selected as group A.The patients were in group B,40 patients with DN with massive urinary protein were in group C,and 40 patients with normal physical examination were in the control group.The bone metabolism indexes[type I collagen N-terminal prolonger(PINP),β-type I collagen carboxy-terminal peptide(β-CTX)],bone mineral density indicators(proximal femur bone mineral density),serum 25-OH-D3,BMP2,RBP4 of the four groups were compared,and analyzed correlation of serum 25-OH-D3,BMP2,RBP4 with bone metabolism indexes and bone mineral density indexes.Results The PINP level in group C was(24.53±6.02)μg/L,which was lower than those of group B,group A and control group[(28.97±5.11),(32.59±5.81),(33.54±5.46)μg/L],β-CTX level was(420.15±42.86)μg/L,which was higher those of group B,group A and control group[(387.65±49.87),(326.87±42.07),(336.58±36.15)μg/L],the difference was statistically significant(P<0.05);the BMD of proximal femur in group C was(0.71±0.11)g/cm~2,which was lower than those in group B,group A and control group[(0.86±0.17),(0.88±0.21),(0.90±0.18)g/cm~2],the difference was statistically significant(P<0.05).The levels of 25-OH-D3and RBP4 in group C were(7.26±2.09)and(4.92±1.33)μg/L,respectively,which were lower than those in group B[(12.38±2.84),(7.42±2.21)μg/L],group A[(12.99±3.01),(7.67±2.06)μg/L],and control group[(10.36±2.47),(5.97±1.59)μg/L],BMP2 level was(40.07±5.81)μg/L,which was higher than those of group B,group A and control group[(37.11±5.29),(34.05±6.27),(33.25±6.14)μg/L],the differences were statistically significant(P<0.05).Pearson correlation analysis showed that 25-OH-D3and R

关 键 词：糖尿病肾病 25-羟维生素D3 骨形态发生蛋白2 视黄醇结合蛋白4 骨代谢 骨密度 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]