2型糖尿病患者不同骨代谢状态下血清Omentin-1水平的变化及预测价值  

Changes and predictive value of serum Omentin-1 levels in patients with type 2 diabetes under different bone metabolic states

作　　者：李宗虎 朱明明[2] 郑宪玲[2] 王颖霞[2] 张树杰[2] LI Zonghu;ZHU Mingming;ZHENG Xianling;WANG Yingxia;ZHANG Shujie(Department of Health Examination,Handan Central Hospital,Handan,Hebei 056001,China;First Department of Endocrinology,Handan Central Hospital,Handan,Hebei 056001,China)

机构地区：[1]邯郸市中心医院健康体检科,河北邯郸056001 [2]邯郸市中心医院内分泌一科,河北邯郸056001

出　　处：《国际检验医学杂志》2024年第4期410-415,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题项目(20210509)。

摘　　要：目的探讨2型糖尿病(T2DM)患者不同骨代谢状态下血清网膜素-1(Omentin-1)水平的变化及预测价值。方法选取2021年6月至2022年12月就诊于该院的120例T2DM患者,按骨密度不同分为A组(骨量正常,T值≥-1.0,36例)、B组(骨量减少,-2.5<T值<-1.0,49例)、C组(骨质疏松,T值≤-2.5,35例),另选同期于该院体检的50例健康者作为健康对照组。对比4组基础资料、血清Omentin-1与骨代谢水平,经Pearson相关性分析血清Omentin-1水平与骨代谢、血糖水平的相关性,多元逐步回归分析影响T2DM患者骨密度的因素,绘制受试者工作特征(ROC)曲线分析血清Omentin-1水平对T2DM伴骨质疏松的预测价值。结果A组、B组、C组空腹血糖(FBG)水平高于健康对照组,健康对照组、A组、B组糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)低于C组,差异有统计学意义(P<0.05)。健康对照组、A组、B组Omentin-1、Ⅰ型前胶原N端前肽(PⅠNP)、骨钙素(BGP)高于C组,健康对照组、A组、B组Ⅰ型胶原羧基端肽β特殊序列(β-CTX)低于C组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,T2DM患者血清Omentin-1水平与HbA1c、HOMA-IR、β-CTX水平呈负相关(r=-0.770、-0.807、-0.759,P<0.05),与PⅠNP、BGP水平呈正相关(r=0.868、0.879,P<0.05),与FBG水平无明显相关性(r=-0.085,P=0.152)。Omentin-1、PⅠNP、β-CTX、BGP、HbA1c、HOMA-IR均是T2DM患者骨密度的独立影响因素(P<0.05)。ROC曲线分析结果发现,血清Omentin-1水平预测T2DM伴骨质疏松的曲线下面积为0.835(95%CI:0.764~0.906),当截断值取50.325 ng/mL时,其灵敏度为0.854,特异度为0.801,约登指数为0.655。结论T2DM患者血清Omentin-1呈低表达,其表达与T2DM患者骨密度、骨代谢、胰岛素抵抗密切相关,且可有效预测T2DM伴骨质疏松的发生。Objective To investigate the changes and predictive value of Omentin-1 levels in patients with type 2 diabetes mellitus(T2DM)under different bone metabolic status.Methods A total of 120 T2DM patients admitted to a hospital from June 2021 to December 2022 were selected and divided into group A(normal bone mass,T-value≥-1.0,36 cases),Group B(bone loss,-2.5<T-value<-1.0,49 cases)and group C(osteoporosis,T-value≤-2.5,35 cases)according to different bone mineral density.Another 50 healthy subjects who underwent physical examination in a hospital during the same period were selected as the healthy control group.Basic data,serum Omentin-1 and bone metabolism levels of the 4 groups were compared,and the correlation between serum Omentin-1 and bone metabolism and blood glucose levels was analyzed by Pearson correlation analysis.Multiple stepwise regression analysis was conducted to analyze the factors affecting bone mineral density in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Omentin-1 level in T2DM with osteoporosis.Results The fasting blood glucose(FBG)level of groups A,B and C was higher than that of healthy control group,and the hemoglobin A1c(HbA1c)and homeostasis model assessment of insulin resistance(HOMA-IR)of healthy control group,group A and group B were lower than that of group C,with statistical significance(P<0.05).Omentin-1,typeⅠprocollagen N-terminal propeptide(PⅠNP)and osteocalcin(BGP)in healthy control group,group A and group B were higher than those in group C,while theβ-CTX sequence of typeⅠcollagen in healthy control group,group A and group B was lower than that in group C,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the serum Omentin-1 level in T2DM patients was negatively correlated with the levels of HbA1c,HOMA-IR andβ-CTX(r=-0.770,-0.807,-0.759,P<0.05),and positively correlated with the levels of PⅠNP and BGP(r=0.868,0.879,P<0.05),but no significant correlation with

关 键 词：2型糖尿病 骨代谢 网膜素-1 骨质疏松 

分 类 号：R587.1[医药卫生—内分泌]