老年2型糖尿病和糖耐量受损患者血清骨钙素、胎球蛋白A与胰岛素抵抗和胰岛β细胞功能的相关性  

Correlation of Serum Osteocalcin and Fetuin A with Insulin Resistance and Isletβ-cell Function in Elderly Patients with Type 2 Diabetes Mellitus and Impaired Glucose Tolerance

作　　者：高雷[1] 薛阳利 王月 魏玲云 高菲 王敏[1] 张静[1] 焦杨[1] 张美丽 杨妙妍 GAO Lei;XUE Yangli;WANG Yue;WEI Lingyun;GAO Fei;WANG Min;ZHANG Jing;JIAO Yang;ZHANG Meili;YANG Miaoyan(Department of Endocrinology,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院内分泌科,西安710004

出　　处：《医学综述》2023年第4期811-815,共5页Medical Recapitulate

基　　金：陕西省重点研发计划项目(2020SF-165);西安交通大学第二附属医院科研基金自由探索项目(2020YJ(ZYTS)075)。

摘　　要：目的分析老年2型糖尿病(T2DM)和糖耐量受损(IGT)患者血清骨钙素、胎球蛋白A水平与胰岛素抵抗(IR)和胰岛β细胞功能的相关性。方法选择2019年1月至2021年3月西安交通大学第二附属医院内分泌科诊治的97例老年T2DM患者(T2DM组)以及59例老年IGT患者(IGT组)作为研究对象,选择同期63名健康体检者为对照组。分别检测各组糖脂代谢指标[三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2 h BG)、糖化血红蛋白(HbA 1c)]、空腹胰岛素(FINS)、空腹C肽(FCP)、骨钙素、胎球蛋白A水平,并计算稳态模型评估的IR指数(HOMA-IR)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)。结果与对照组相比,T2DM组和IGT组LDL-C、FBG、2 h BG、HbA 1c、FINS、HOMA-IR水平均显著升高(P<0.05),且T2DM组高于IGT组(P<0.05),T2DM组和IGT组FCP、HOMA-β水平均显著降低(P<0.05),且T2DM组低于IGT组(P<0.05);T2DM组TG水平高于对照组(P<0.05),但IGT组与对照组TG水平比较差异无统计学意义(P>0.05)。与对照组相比,IGT与T2DM组患者骨钙素水平均显著降低,胎球蛋白A水平显著升高(P<0.05),且T2DM组骨钙素水平低于IGT组,胎球蛋白A水平高于IGT组(P<0.05)。T2DM患者血清骨钙素水平与HOMA-IR、FINS、HbA 1c呈负相关(均P<0.01),与HOMA-β呈正相关(P<0.01),与FCP无相关性(P>0.05)。T2DM患者血清胎球蛋白A水平与HOMA-IR、FINS、HbA 1c呈正相关(均P<0.01),与HOMA-β、FCP呈负相关(均P<0.01)。结论老年T2DM和IGT患者血清骨钙素、胎球蛋白A水平存在明显差异,两者有望成为评估老年T2DM患者胰岛β细胞功能、IR的可靠指标。Objective To analyze the correlation of serum osteocalcin and fetuin A with insulin resistance(IR)and isletβ-cell function in elderly patients with type 2 diabetes mellitus(T2DM)and impaired glucose tolerance(IGT).Methods Ninety-seven elderly patients with T2DM(T2DM group)and 59 elderly patients with IGT(IGT group)diagnosed and treated in the Department of Endocrinology,the Second Affiliated Hospital of Xi′an Jiaotong University from Jan.2019 to Mar.2021 were included,and 63 healthy individuals during the same period were included as a control group.The levels of glucose and lipid metabolism indicators[triglycerides(TG),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),2 h postprandial blood glucose(2 h BG)and glycosylated hemoglobin(HbA 1c)],fasting insulin(FINS),fasting C peptide(FCP),osteocalcin,and fetuin A were detected.Homeostasis model assessment(HOMA)-IR and HOMA-βwere calculated.Results Compared with the control group,the levels of LDL-C,FBG,2 h BG,HbA 1c,FINS and HOMA-IR in the T2DM and the IGT group were significantly increased(P<0.05),and those in the T2DM group were higher than those in the IGT group(P<0.05).The levels of FCP and HOMA-βin the T2DM and the IGT group were significantly decreased(P<0.05),and those in the T2DM group were lower than those in the IGT group(P<0.05).The TG level of the T2DM group was higher than that of the control group(P<0.05),but there was no significant difference in TG level between the IGT group and control group(P>0.05).Compared with the control group,the level of osteocalcin in the IGT group and T2DM group was significantly decreased,and the level of fetuin A was significantly increased(P<0.05).The level of osteocalcin in the T2DM group was lower than that in the IGT group,and the level of fetoglobulin A was higher than that in the IGT group(P<0.05).Serum osteocalcin level in T2DM patients was negatively correlated with HOMA-IR,FINS and HbA 1c(all P<0.01),positively correlated with HOMA-β(P<0.01),but not correlated with FCP(P>0.05).Serum fet

关 键 词：2型糖尿病 糖耐量受损 骨钙素 胰岛素抵抗 胰岛Β细胞 

分 类 号：R587.1[医药卫生—内分泌]