2型糖尿病患者LCN2、OPG/RANKL信号通路关键因子相关性及对骨质疏松的预测效能  

Correlation of Key Factors of LCN2 and OPG/RANKL Signaling Pathways in Type 2 Diabetes Patients and Their Efficacy in Predicting Osteoporosis

作　　者：徐云 白立炜[1] 王迪[1] 耿锐娜 刘北彦 XU Yun;BAI Liwei;WANG Di;GENG Ruina;LIU Beiyan(Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院内分泌科,河南新乡453100

出　　处：《河南医学研究》2023年第15期2744-2748,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190463)。

摘　　要：目的探讨2型糖尿病(T2DM)患者脂质运载蛋白-2(LCN2)、护骨素/核因子κB受体活化因子配体(OPG/RANKL)信号通路关键因子相关性及对骨质疏松的预测效能。方法选取2020年1月至2022年12月新乡医学院第一附属医院收治的140例T2DM患者作为研究组,根据骨密度T值将其分为骨质疏松亚组、骨量减少亚组、骨量正常亚组,另按照1∶1比例纳入140例同期健康体检者作为对照组。统计两组血清LCN2及外周血单个核细胞OPG/RANKL信号通路关键因子表达,采用Pearson及相加模型分析LCN2与OPG/RANKL信号通路关键因子关系,绘制受试者工作特征(ROC)曲线,根据曲线下面积(AUC)分析LCN2、OPG/RANKL信号通路关键因子联合预测T2DM患者骨质疏松的效能。结果骨质疏松亚组LCN2、RANKL mRNA和LCN2、RANKL蛋白>骨量减少亚组>骨量正常亚组>对照组,OPG mRNA和OPG蛋白<骨量减少亚组<骨量正常亚组<对照组(P<0.05)。LCN2、RANKL mRNA和LCN2、RANKL蛋白与骨密度呈正相关,OPG mRNA和OPG蛋白与骨密度呈负相关(P<0.001)。当LCN2、RANKL mRNA和LCN2、RANKL蛋白同时暴露,T2DM患者骨质疏松发生风险是非暴露的4.875、1.462倍;当LCN2、OPG mRNA和LCN2、OPG蛋白同时暴露,T2DM患者骨质疏松发生风险是非暴露的4.643、6.734倍。LCN2联合OPG/RANKL信号通路关键因子预测T2DM骨质疏松的效能优于单一预测。结论T2DM患者LCN2、OPG、RANKL mRNA和LCN2、OPG、RANKL蛋白呈异常表达,且LCN2与OPG、RANKL mRNA和OPG、RANKL蛋白存在交互作用,联合检测有助于提高T2DM患者骨质疏松预测效能,为临床诊治提供有利依据。Objective To explore correlation of key factors of lipocalin-2(LCN2)and osteoprotegerin/receptoractivator of nuclear factor-κB ligand(OPG/RANKL)signaling pathways in type 2 diabetes(T2DM)patients and their efficacy in predicting osteoporosis.Methods A total of 140 patients with T2DM admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2020 to December 2022 were selected as the study group,and were divided into subgroup of osteoporosis,subgroup of bone mass loss and subgroup of normal bone mass according to the results of bone density T-value.In addition,a total of 140 healthy patients during the same period were included as the control group in a ratio of 1∶1.The expression of LCN2 and key factors of OPG/RANKL signaling pathway in serum peripheral blood mononuclear cells of the two groups was analyzed,Pearson and additive models were used to analyze the relationship between LCN2 and key factors in OPG/RANKL signaling pathways,and draw the receiver operating characteristic(ROC)curve,and area under the curve(AUC)were used to analyze the combined prediction efficacy of LCN2 and key factors of OPG/RANKL signaling pathways for T2DM osteoporosis.Results Comparison of LCN2,RANKL mRNA and LCN2,RANKL protein:osteoporosis subgroup>bone mass reduction subgroup>bone mass normal subgroup>control group,OPG mRNA and OPG protein comparison:osteoporosis subgroup<bone mass reduction subgroup<bone mass normal subgroup<control group(P<0.05).LCN2,RANKL mRNA and LCN2,RANKL protein were positively correlated with bone density,while OPG mRNA and OPG protein were negatively correlated with bone density(P<0.001).When LCN2,RANKL mRNA and LCN2,RANKL protein were simultaneously exposed,the risk of osteoporosis in T2DM patients was 4.875 and 1.462 times higher than that of non-exposed patients.When LCN2,OPG mRNA and LCN2,OPG protein were simultaneously exposed,the risk of osteoporosis in T2DM patients was 4.643 and 6.734 times higher than that of non-exposed patients.The combination of LCN2 and OPG/RANKL signa

关 键 词：2型糖尿病 骨质疏松 脂质运载蛋白-2 护骨素 核因子ΚB受体活化因子配体 

分 类 号：R587.1[医药卫生—内分泌]