血清FGF1、NT5E、25(OH)D在T2DM伴骨质疏松患者中的表达及与糖脂代谢、骨代谢的关系  

Expression of Serum FGF1,NT5E and 25(OH)D in T2DM Patients with Osteoporosis and Their Association with Glucose and Lipid Metabolism and Bone Metabolism

作　　者：史双伟 解丽然 方一凡 饶小娟[1] SHI Shuangwei;XIE Liran;FANG Yifan;RAO Xiaojuan(Department of Endocrinology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院内分泌科,河南郑州450000

出　　处：《河南医学研究》2024年第18期3299-3303,共5页Henan Medical Research

摘　　要：目的探讨血清碱性成纤维细胞生长因子1(FGF1)、人胞外5’-核苷酸酶(NT5E)、25-羟维生素D[25(OH)D]在2型糖尿病(T2DM)伴骨质疏松患者中的表达,并分析其与糖脂代谢、骨代谢的关系。方法选取2021年1月至2023年6月郑州大学第五附属医院收治的94例T2DM伴骨质疏松患者,另选取同期94例未伴骨质疏松T2DM患者,分别纳入伴骨质疏松组、未伴骨质疏松组。比较两组血清FGF1、NT5E、25(OH)D水平及糖脂代谢、骨代谢相关指标水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、稳态模型测算胰岛素抵抗指数(HOMA-IR)、骨碱性磷酸酶(B-ALP)、骨钙素N-端中分子片段(N-MID)、Ⅰ型胶原羧基端肽β-胶原特殊序列(β-CTX)、骨钙素(OCN)、抗酒石酸盐酸性磷酸酶异构体5b(TRACP-5b)、Ⅰ型前胶原氨基端前肽(PⅠNP)];比较不同骨质疏松程度患者血清FGF1、NT5E、25(OH)D水平,分析三项指标与糖脂代谢、骨代谢及骨质疏松程度的相关性,并评估其诊断效能。结果伴骨质疏松组血清FGF1、NT5E、HbA1c、HOMA-IR、TC、N-MID、β-CTX、OCN、TRACP-5b水平高于未伴骨质疏松组,25(OH)D、B-ALP、PⅠNP低于未伴骨质疏松组(P<0.05);不同骨质疏松程度患者血清FGF1、NT5E水平比较,3度患者低于2度患者,2度患者低于1度患者,25(OH)D水平比较,3度患者高于2度患者,2度患者高于1度患者(P<0.05);血清FGF1、NT5E与HbA1c、HOMA-IR、TC、N-MID、β-CTX、OCN、TRACP-5b呈正相关,与B-ALP、PⅠNP及骨质疏松程度呈负相关,血清25(OH)D与HbA1c、HOMA-IR、TC、N-MID、β-CTX、OCN、TRACP-5b呈负相关,与B-ALP、PⅠNP及骨质疏松程度呈正相关,且各指标联合诊断骨质疏松的曲线下面积(AUC)为0.923,大于三指标单独诊断(P<0.05)。结论FGF1、NT5E在T2DM伴骨质疏松患者血清中表达上调,25(OH)D表达下调,各指标水平与Objective To investigate the expression of serum basic fibroblast growth factor 1(FGF1),human ecto-5’-nucleotidyase(NT5E),and 25-hydroxyvitamin D[25(OH)D]in type 2 diabetes mellitus(T2DM)patients with osteoporosis,and to analyze their association with glucose and lipid metabolism and bone metabolism.Methods A total of 94 T2DM patients with osteoporosis and 94 T2DM patients without osteoporosis were selected from the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023,and were included in the group with osteoporosis and the group without osteoporosis,respectively.The levels of serum FGF1,NT5E,25(OH)D and the related indexes of glucose and lipid metabolism and bone metabolism glycated hemoglobin A1c(HbA1c),fasting blood glucose(FPG),fasting insulin(FINS),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),total cholesterol(TC),homeostasis model assessment insulin resistance index(HOMA-IR),bone alkaline phosphatase(B-ALP),N-terminal med fragment of osteocalcin(N-MID),β-isomer of the C-terminal telopeptide of typeⅠcollagen(β-CTX),osteocalcin(OCN),tartrate-resistant acid phosphatase 5b(TRACP-5b),procollagen TypeⅠN-terminal propeptide(PⅠNP)were compared between the two groups.The serum levels of FGF1,NT5E and 25(OH)D were compared in patients with different degrees of osteoporosis,and the correlation between these three indexes and glucose and lipid metabolism,bone metabolism and osteoporosis degree was analyzed,and their diagnostic efficacy was evaluated.Results The levels of serum FGF1,NT5E,HbA1c,HOMA-IR,TC,N-MID,β-CTX,OCN and TRACP-5b in the group with osteoporosis were higher than those in the group without osteoporosis,and the levels of 25(OH)D,B-ALP and PⅠNP were lower than those in the non-osteoporosis group(P<0.05).Comparison of serum FGF1 and NT5E levels in patients with different degrees of osteoporosis showed that patients with degree 3 were lower than those with degree 2,and patients with degree 2 were lower than those with degree 1.The

关 键 词：碱性成纤维细胞生长因子1 人胞外5’-核苷酸酶 25-羟维生素D 2型糖尿病 骨质疏松 糖脂代谢 骨代谢 

分 类 号：R587[医药卫生—内分泌]