合并非酒精性脂肪肝的老年2型糖尿病患者血清骨代谢与糖脂代谢关系分析  

Correlation of bone metabolism with glucose and lipid metabolism in elderly patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease

作　　者：王芸 闵玺 王磊 常湛[1] 崔杰[1] 张硕 张莉莉[1] WANG Yun;MIN Xi;WANG Lei(Department of Endocrinology,The Second Hospital of Shijiazhuang,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市第二医院内分泌科,050056 [2]河北省石家庄市高新区长江社区卫生服务中心

出　　处：《河北医药》2024年第7期1052-1055,共4页Hebei Medical Journal

基　　金：河北省卫生健康委医学科学研究课题计划项目(课题号:20241865)。

摘　　要：目的探究合并非酒精性脂肪肝的老年2型糖尿病血清骨代谢与糖脂代谢关系。方法选取非酒精性脂肪肝的老年2型糖尿病患者100例为研究对象,选取100例健康体检者为对照组,比较2组患者一般情况、糖脂代谢指标及肝功指标,Pearson相关性分析骨钙素与糖脂代谢各指标的关系,以骨钙素作为因变量,差异指标作为自变量行多因素Logistic回归,分析合并非酒精性脂肪肝的老年2型糖尿病血清骨代谢(骨钙素)与糖脂代谢关系。结果2型糖尿病合并非酒精性脂肪肝组的胰岛素抵抗指数、空腹血糖、胰岛素、体质指数、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶水平均明显高于对照组(P<0.05),总骨钙素、高密度脂蛋白胆固醇(HDL-C)均低于对照组(P<0.05)。Pearson相关结果显示,骨钙素与空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数、胰岛素分泌指数、三酰甘油、总胆固醇、LDL-C及体重指数呈负相关,与HDL-C呈正相关(P<0.05)。将骨钙素作为因变量,而空腹血糖、体质指数、胰岛素分泌指数、LDL-C、总胆固醇、糖化血红蛋白、HDL-C、胰岛素抵抗指数作为自变量行多重线性回归分析得出,糖化血红蛋白是影响骨钙素的独立因素(P<0.05)。结论合并非酒精性脂肪肝的老年2型糖尿病患者血清骨代谢与糖脂代谢存在相关性,临床应引起重视。Objective To explore the correlation of bone metabolism with glucose and lipid metabolism in elderly patients with type 2 diabetes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 100 elderly T2DM patients combined with NAFLD admitted from February 2020 to February 2022 were included,and 100 healthy subjects receiving physical examinations were selected as the control group.The general conditions,indicators of glucose and lipid metabolism and liver function were compared between groups.Pearson correlation analysis was conducted to analyze the correlation of osteocalcin with glucose and lipid metabolism indicators.Using osteocalcin as the dependent variable and differentially expressed indicators as the independent variables,multivariate Logistic regression was performed to analyze the correlation of serum osteocalcin with glucose and lipid metabolism in elderly T2DM patients combined with NAFLD.Results Elderly T2DM patients combined with NAFLD had significantly higher insulin resistance(IR),fasting blood glucose(FBG),insulin,body mass index(BMI),glycated hemoglobin(HbA1c),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP),but significantly lower total osteocalcin and high-density lipoprotein cholesterol(HDL-C)than those of control group(P<0.05).Pearson correlation showed that serum osteocalcin was negatively correlated with FBG,fasting insulin,HbA1c,IR,insulin secretion,TG,TC,LDL-C and BMI,and positively correlated with HDL-C(P>0.05).Taking osteocalcin as the dependent variable,and FBG,BMI,TC,HbA1c,HDL-C,LDL-C,insulin secretion and IR as independent variables,multiple linear regression analysis showed that HbA1c was an independent factor affecting the level of osteocalcin in elderly T2DM patients with NAFLD(P<0.05).Conclusion Serum bone metabolism is correlated with glucose and lipid metabolism in elderly T2DM patients with NAFLD,which should be paid a

关 键 词：非酒精性脂肪肝 老年 2型糖尿病 骨代谢 糖脂代谢 

分 类 号：R575.5[医药卫生—消化系统]