糖尿病肾病患者血清肿瘤标志物水平与骨密度的相关性研究  

Correlation between Serum Tumor Markers and Bone Mineral Density in Patients with Diabetic Kidney Disease

作　　者：付彩雯[1] 吴艳[1] 喻荷淋[1] 李元美 Fu Caiwen;Wu Yan;Yu Helin;Li Yuanmei(Department of Endocrinology and Metabolism,Suining Central Hospital,Suining 629000,Sichuan,China)

机构地区：[1]遂宁市中心医院内分泌代谢病科,四川遂宁629000

出　　处：《肿瘤预防与治疗》2023年第7期584-589,共6页Journal of Cancer Control And Treatment

基　　金：四川省中医药管理局中医药科研专项课题(编号:2020LC0215)。

摘　　要：目的:分析糖尿病肾病(diabetic kidney disease,DKD)患者主要肿瘤标志物(tumor markers,TM)包括癌胚抗原、甲胎蛋白、糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)、糖类抗原125与骨密度(bone mineral density,BMD)的关系,为血清TM在DKD患者骨质疏松的预防和治疗中提供参考依据。方法:选择2020年12月至2022年12月遂宁市中心医院内分泌代谢病科收治的168例DKD患者作为研究对象,将DKD患者按照TM水平分为正常组与升高组,采用双能X线吸收法对DKD患者的正位腰椎(L_(2)-L_(4))和股骨颈BMD进行测量,比较2组BMD的差异;采用Pearson相关性分析TM与BMD之间的相关性,采用基于有序多分类的Logistic回归模型分析TM与骨量异常之间的关系。结果:TM正常组58例(34.52%)、TM升高组110例(65.48%);骨量正常99例(58.93%)、骨量减少45例(26.79%)、骨质疏松(OP)24例(14.29%)。DKD患者血清CA19-9与腰椎(L2-L4)及股骨颈BMD呈负相关关系(r=-0.184,r=-0.191,均P<0.05)。有序多分类的Logistic回归分析,结果显示:CA19-9(OR=2.735)、年龄(OR=1.121)、糖尿病病程(OR=1.679)、FBG(OR=1.302)和TG(OR=1.050)是DKD患者发生OP的独立危险因素,男性(OR=0.135)和BMI(OR=0.757)则是发生OP的独立保护因素。结论:DKD患者中TM的升高可能与BMD降低相关,TM升高组患者的OP发生率更高,CA19-9升高可能是预测DKD患者OP发生的独立危险因素。Objective:To analyze the relationship of main tumor markers(TM)including carcinoembryonic antigen,alpha feto-protein,carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 125 to bone mineral density(BMD)in patients with diabetic kidney disease(DKD),and provide rationale for serum TM in the prevention and treatment of osteoporosis(OP)in DKD patients.Methods:168 patients with DKD admitted to the department of endocrine and metabolic diseases in Suining Central Hospital from December 2020 to December 2022 were selected as the study subjects.DKD patients were assigned to normal and elevated groups according to the level of TM.The BMD of the lumbar spine(L_(2)-L_(4))and femoral neck of DKD patients were measured by dual energy X-ray absorption,and the difference in BMD between the two groups was compared.Pearson correlation was used to analyze the correlation between TM and BMD,and the relationship between TM and abnormal bone mass was analyzed by using ordinal multinomial logistic regression model.Results:58 cases(34.52%)were in the normal TM group,and 110(65.48%)were in the elevated TM group.Normal bone mass occurred in 99 cases(58.93%),decreased bone mass in 45 cases(26.79%),and 0P in 24 cases(14.29%).Serum CA19-9 in DKD patients was negatively correlated to lumbar spine(L-L4)and femoral neck BMD(r=-0.184,r=-0.191,P<0.05).The results of logistic regression analysis showed that CA19-9(OR=2.735),age(OR=1.121),course of diabetes(OR=1.679),fasting plasma glucose(OR=1.302)and triglyceride(OR=1.050)were independent risk factors for OP in DKD patients,while male(OR=0.135)and BMI(OR=0.757)were independent protective factors for OP.Conclusion:The increase of TM in DKD patients may be correlated to the decrease of BMD.The incidence of OP in patients with elevated TM is higher.The increase of CA19-9 may be an independent risk factor for predicting the occurrence of OP in DKD patients.

关 键 词：糖尿病肾病 肿瘤标志物 骨密度 相关性 

分 类 号：R587.1[医药卫生—内分泌] R446.11[医药卫生—内科学]