血清FGF1、NT5E与T2DM合并骨质疏松患者糖脂及骨代谢的相关性  

The correlation between serum FGF1,NT5E and glucose,lipid,and bone metabolism in type 2 diabetes mellitus patients with osteoporosis

作　　者：钟晓敬 姚建平[1] 金月萍[1] 詹碧水[2] Zhong Xiaojing;Yao Jianping;Jin Yueping;Zhan Bishui(Department of Endocrinology,Huzhou Central Hospital,Huzhou 313000,China;Department of Orthopaedics,Huzhou 313000,China)

机构地区：[1]湖州市中心医院内分泌科,湖州313000 [2]湖州市中心医院骨科,湖州313000

出　　处：《中华内分泌外科杂志（中英文）》2024年第2期274-278,共5页Chinese Journal of Endocrine Surgery

基　　金：浙江省2021医药卫生科技计划项目(2022RC074)。

摘　　要：目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松患者血清成纤维细胞生长因子1(fibroblast growth factor,FGF1)、5'-核苷酸酶(ecto-5'-nucleotidase,NT5E)与糖脂代谢及骨代谢的相关性,为临床诊治提供参考。方法选取2020年3月至2023年1月湖州市中心医院收治的T2DM患者180例,根据WHO骨质疏松标准分为骨量正常组62例、骨量减少组65例和骨质疏松组53例,均检测血清FGF1、NT5E水平、人体测量学指标[内脏脂肪面积(visceral fat area,VFA)、体质指数(body mass index,BMI)、皮下脂肪面积(subcutaneous fat area,SFA)]、糖脂代谢指标[糖化血红蛋白(hemoglobin A1c,HbA1c)、总胆固醇(total cholesterol,TC)、空腹血糖(fasting plasma glucose,FPG)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)]及骨代谢指标[总Ⅰ型胶原氨基端肽(total procollagen type 1 amino-terminal propeptide,T-PINP)、总25-羟维生素D(25-hydroxy vitamin D,25-OH-D)、1型胶原羧基端肽β特殊序列(beta C-terminal cross-linked telopeptides of typeⅠcollagen,β-CTX)、骨钙素N端中分子片段(N-terminal mid-fragment,N-MID)、骨钙素(osteocalcin,OCN)],分析FGF1、NT5E与糖脂代谢、骨代谢指标的相关性T2DM患者发生骨质疏松症的关系。结果骨量正常组血清FGF1、NT5E水平<骨量减少组<骨质疏松组(F=690.73、290.76,P<0.05);骨量正常组BMI、VFA、SFA水平>骨量减少组>骨质疏松组(F=12.91、40.65、23.17,P<0.05);三组TC、FPG、TG、HbA1c、LDL-C、HDL-C水平比较差异无统计学意义(F=0.38、2.53、2.29、1.57、0.72、2.59,P>0.05),骨量正常组N-MID、T-PINP、25-OH-D水平>骨量减少组>骨质疏松组(F=17.64、24.84、10.45,P<0.05);骨量正常组β-CTX、OCN水平<骨量减少组<骨质疏松组(F=21.43、46.06,P<0.05);血清FGF1、NT5E与N-MID、T-PINP、25-OH-D呈负相关(r_(1)=-0.514、-0.583、-0.607,r_(2)=-0.525�Objective To analyze the correlation between serum fibroblast growth factor 1(FGF1),ecto-5'-nucleotidase(NT5E)and glucose and lipid metabolism and bone metabolism in patients with type 2 diabetes mellitus(T2DM)complicated with osteoporosis,and to provide reference for clinical diagnosis and treatment.Methods A total of 180 T2DM patients admitted to our hospital from Mar.2020 to Jan.2023 were selected and divided into 62 normal bone mass group,65 decreased bone mass group and 53 osteoporosis group according to WHO osteoporosis criteria.Serum FGF1,NT5E levels,human body measurements[visceral fat area(VFA),body mass index(BMI),subcutaneous fat area(SFA)],hemoglobin A1c[HbA1c),total cholesterol(TC),fasting plasma glucose(FPG),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and bone metabolism indicators[total procollagen type 1 amino-terminal propeptide(T-PINP),total 25-hydroxy vitamin D(25-OH-D),beta C-terminal cross-linked telopeptides of typeⅠcollagen(β-CTX),N-terminal mid-fragment(N-MID),osteocalcin(OCN)]were detected.The correlation between FGF1,NT5E,glucose and lipid metabolism,bone metabolism indicators,and the occurrence of osteoporosis in T2DM patients were analyzed.Results The levels of FGF1 and NT5E in normal bone mass group were lower than those in osteopenia group and osteoporosis group(F=690.73,290.76,P<0.05).The levels of BMI,VFA and SFA in normal bone mass group were higher than those in decreasing bone mass group>osteoporosis group(F=12.91,40.65、23.17,P<0.05).There was no significant difference in the levels of TC,FPG,TG,HbA1c,LDL-C and HDL-C among the three groups(F=0.38,2.53,2.29,1.57,0.72,2.59,P>0.05).The levels of N-MID,T-PINP and 25-OH-D in the normal bone mass group were higher than those in the osteopenia group>those in the osteoporosis group(F=17.64,24.84,10.45,P<0.05).The levels ofβ-CTX and OCN in normal bone mass group were lower than those in osteopenia group<osteoporosis group(F=21.43,46.06,P<0.05).Serum FGF1 and NT5E were nega

关 键 词：2型糖尿病 糖脂代谢 骨质疏松 成纤维细胞生长因子1 5'-核苷酸酶 骨代谢 

分 类 号：R587.2[医药卫生—内分泌] R580[医药卫生—内科学]