PINP与β-CTX在2型糖尿病合并骨质疏松症预测诊断中的应用  

Application of N-terminal propeptide of type Ⅰ procollagen and carboxy-terminal peptideβin prediction and diagnosis of type 2 diabetes mellitus complicated with osteoporosis

作　　者：孙景熙 陈剑明[1] 王福斌[1] SUN Jing-xi;CHEN Jian-ming;WANG Fu-bin(Ningbo Sixth Hospital,Zhejiang 315040,China)

机构地区：[1]宁波市第六医院,浙江315040

出　　处：《中国卫生检验杂志》2023年第21期2618-2621,共4页Chinese Journal of Health Laboratory Technology

基　　金：宁波市鄞州区科技计划项目(鄞科[2018]74号)。

摘　　要：目的探讨骨形成指标Ⅰ型前胶原N-端前肽(PINP)和骨吸收指标I型胶原羧基端肽β特殊序列(β-CTX)检测在2型糖尿病合并骨质疏松患者中的应用价值。方法选取2型糖尿病患者140例,其中男性60例,女性80例,运用电化学发光法(ECL)检测血清中PINP和β-CTX的表达水平。用双能X线吸收测量仪进行测量,以其结果为标准,分析DXA参数包括股骨颈、腰椎及髋部整体的骨密度与PINP和β-CTX的相关性,绘制受试者工作曲线(ROC)。结果男性和女性,2型糖尿病合并骨质疏松组PINP、β-CTX、25(OH)D,均低于非骨质疏松组,PINP和β-CTX与DXA测量的骨密度为负相关关系,男性PINP与DXA相关系数(r)为-0.124~-0.374,男性β-CTX与DXA相关系数(r)为-0.257~-0.425;女性PINP与DXA相关系数(r)为-0.167~-0.201,女性β-CTX与DXA相关系数(r)为-0.231~-0.348。PINP与β-CTX均能预测腰椎骨质疏松症,其阈值分别为52.23ng/ml、0.37ng/ml;PINP与β-CTX也能预测髋部骨质疏松症其阈值分别为53.39ng/ml、0.39ng/ml。结论PINP与β-CTX与T2DM合并骨质疏松症腰椎和髋部骨密度相关,对于预测T2DM合并骨质疏松症有意义,其诊断阈值根据部位、性别的不同而略有不同,值得临床推广。Objective This paper aims to investigate the application value of bone formation indicator[N-terminal propeptide of type Ⅰ procollagen(PINP)]and bone resorption indicator[carboxy-terminal peptideβof type I special sequence(β-CTX)]in patients with type 2 diabetes mellitus complicated with osteoporosis.Methods The levels of serum PINP andβ-CTX in 140 patients with type 2 diabetes mellitus(60 males and 80 females)were determined by electrochemiluminescence(ECL).Dual energy X-ray absorptiometry(DXA)was used to measure and the results were set as the criterion.The correlation of DXA indicators[the bone mineral densities(BMD)of femoral neck,lumbar spine and hip as a whole]with PINP andβ-CTX was analyzed,and receiver operating characteristic(ROC)curve was drawn.Results PINP,β-CTX,and 25(OH)D,in the group with osteoporosis were lower than those in the type 2 diabetes mellitus group without osteoporosis in both men and women.The bone mineral density measured by DXA was negatively correlated with PINP andβ-CTX.The correlation coefficient(r)between PINP and DXA in males was-0.124-0.374,and the correlation coefficient(r)betweenβ-CTX and DXA in males was ranged from-0.257 to-0.425.The correlation coefficient(r)between female PINP and DXA was ranged from-0.167 to-0.201,and the correlation coefficient(r)between femaleβ-CTX and DXA was ranged from-0.231 to-0.348.Both PINP andβ-CTX could predict lumbar osteoporosis,and the thresholds were 52.23 ng/ml and 0.37 ng/ml,respectively.The thresholds of PINP andβ-CTX predicting hip osteoporosis were 53.39 ng/ml and 0.39 ng/ml,respectively.Conclusion PINP andβ-CTX are correlated with BMD of lumbar spine and hip in T2DM complicated with osteoporosis,which is significant for predicting T2DM complicated with osteoporosis.The diagnostic threshold is slightly dfferent according to different location and gender,which is worthy of clinical promotion.

关 键 词：骨转换标志物 2型糖尿病 骨质疏松 骨密度 相关性 

分 类 号：R587.1[医药卫生—内分泌]