绝经后2型糖尿病患者瘦素、骨代谢标志物与OP的关系  

Relationship between leptin,bone metabolic markers and OP in postmenopausal patients with type 2 diabetes mellitus

作　　者：齐晨蕊[1] 杨乐[1] 马彦[1] 谢立凯[1] 关红[1] 孙亚东 Qi Chenrui;Yang Le;Ma Yan;Xie Likai;Guan Hong(Department of Endocrinology and Metabolism,Jilin Provincial People′s Hospital,Changchun 130021,China)

机构地区：[1]吉林省人民医院内分泌代谢病一科,长春130021 [2]不详

出　　处：《国际内分泌代谢杂志》2024年第3期177-182,共6页International Journal of Endocrinology and Metabolism

摘　　要：目的探析绝经后2型糖尿病(T2DM)患者瘦素、骨代谢标志物与骨质疏松症(OP)的相关性。方法回顾性纳入2020年1月至2021年12月在我院内分泌科治疗的109例绝经后T2DM患者,并依据骨密度(BMD)测定结果将其分为正常组(n=33)、减少组(n=37)、OP组(n=39)。对比3组患者一般资料及实验室指标差异。采用多因素logistic回归分析确定绝经后T2DM患者发生OP独立危险因素;并运用Pearson相关性分析瘦素、骨代谢标志物与OP的相关性。结果OP组甲状腺功能亢进症(以下简称甲亢)患者占比、促甲状腺激素(TSH)、糖化血红蛋白A1c(HbA1c)、瘦素、Ⅰ型胶原羟基端肽(β-CTX)高于正常组与减少组,胰岛素治疗占比、25-羟基维生素D[25(OH)D]、骨钙素、总骨Ⅰ型前胶原N端肽(TPINP)低于正常组与减少组(P<0.05);多因素logistic回归分析结果显示:甲亢患者、血清瘦素、β-CTX为绝经后T2DM患者发生OP独立危险因素(P<0.05),胰岛素治疗、25(OH)D、骨钙素、TPINP为绝经后T2DM患者发生OP保护因素(P<0.05);Pearson相关性分析显示:血清25(OH)D、骨钙素、TPINP与OP呈正相关(P<0.05);血清瘦素、β-CTX与OP呈负相关(P<0.05)。结论瘦素与骨代谢标志物可反映绝经后T2DM患者早期骨代谢情况,预测OP发生风险;合并甲亢患者、瘦素、β-CTX水平升高、用胰岛素治疗、25(OH)D、骨钙素、TPINP水平降低,可能共同参与绝经后T2DM患者OP发生发展。Objective To investigate the correlation between leptin(LEP),bone metabolism markers,and osteoporosis(OP)in postmenopausal patients with type 2 diabetes mellitus(T2DM).Methods 109 postmenopausal T2DM patients treated in endocrinology department of our hospital from January 2020 to December 2021 were retrospectively included and divided into normal group(n=33),reduced group(n=37)and OP group(n=39)according to bone mineral density(BMD)measurement results.The differences of general data and laboratory indexes among the three groups were compared.Multivariate logistic regression analysis was used to determine the independent risk factors for OP in postmenopausal T2DM patients.The correlations between LEP,bone metabolism markers and OP were analyzed by Pearson correlation.Results The ratio of hyperthyroidism,thyroid stimulating hormone(TSH),glycosylated hemoglobin(HbA1c),LEP andβ-CTX of type I collagen in OP group were higher than those in normal group and reduced group.The proportion of insulin treatment,25-hydroxyvitamin D[25(OH)D],osteocalcin(BGP)and Nterminal peptide of total bone type I procollagen(TPINP)were lower than those in normal and reduced groups(P<0.05).Multivariate logistic regression analysis showed that hyperthyroidism,serum LEP andβ-CTX were independent risk factors for OP in postmenopausal T2DM patients(P<0.05),and insulin therapy,25(OH)D,BGP and TPINP were protective factors for OP in postmenopausal T2DM patients(P<0.05).Pearson correlation analysis showed that serum 25(OH)D,BGP,TPINP were positively correlated with OP(P<0.05).Serum LEP andβ-CTX were negatively correlated with OP(P<0.05).Conclusion LEP and bone metabolism markers can reflect the early bone metabolism of postmenopausal T2DM patients and predict the risk of OP.Combined hyperthyroidism,LEP,β-CTX levels increased,insulin treatment,25(OH)D,BGP,TPINP levels decreased,which may be involved in the development of OP in postmenopausal T2DM patients.

关 键 词：2型糖尿病 骨质疏松症 瘦素 骨代谢标志物 

分 类 号：R587.1[医药卫生—内分泌]