2型糖尿病患者血清骨钙素水平与胰岛β细胞功能相关性分析  

Association between osteocalcin level and pancreaticβ-cell function in type 2 diabetes patients

作　　者：张萌 梁琳琅[1] 童慧昕 ZHANG Meng;LIANG Lin-lang;TONG Hui-xin(Department of Endocrinology,Chinese People's Liberation Army Northern Theater Command General Hospital,Shenyang 110016,China)

机构地区：[1]北部战区总医院内分泌科,辽宁沈阳110016 [2]大连医科大学北部战区总医院研究生培养基地,辽宁沈阳110016

出　　处：《中国实用内科杂志》2024年第8期675-679,共5页Chinese Journal of Practical Internal Medicine

基　　金：全军保健专项科研课题(15BJZ01)。

摘　　要：目的通过探讨2型糖尿病患者血清骨钙素(osteocalcin,OC)水平与胰岛β细胞分泌功能的相关性,深入了解骨代谢及其产物在糖尿病发病机制中的作用。方法选取2018年1月至2022年12月就诊于中国人民解放军北部战区总医院内分泌科住院部的2型糖尿病患者680例。根据OC四分位数水平分为四组。详细采集患者的基本信息和生化指标。所有受试者接受75 g口服葡萄糖耐量试验(OGTT)及胰岛素释放试验检测胰岛功能,比较四组患者各个时相激素水平,稳态模型胰岛β细胞功能指数(HOMA-β)、180 min内C肽曲线下面积(AUC_(CP180))、葡萄糖曲线下面积(AUC_(PG))和C肽分泌指数。相关性分析采用Pearson相关性分析以及多因素矫正后的线性回归分析。结果随着OC水平的升高,四组患者各个时相胰岛素以及C肽分泌组间观察到呈上升趋势,血糖、糖化血红蛋白(HbA_(1c))呈下降趋势。Pearson相关分析表明Ln-OC与Ln-HOMA-β、Ln-AUC_(CP180)、Ln-C肽分泌指数呈正相关,与HbA_(1c)和Ln-AUC_(PG)呈负相关(P<0.05)。校正混杂因素后进行偏相关分析,结果与上述一致。Ln-HOMA-β、Ln-AUCPG为因变量的简单线性回归和多元线性回归分析结果显示:Ln-OC(β_(1)=0.141,β_(2)=0.113,β_(3)=0.090;β_(1)=-0.179,β_(2)=-0.191,β_(3)=-0.100),P<0.05。结论2型糖尿病患者血清骨钙素水平与胰岛β细胞功能相关。骨钙素是胰岛β细胞的保护因素,可以促进胰岛素分泌,改善胰岛功能。Objective By investigating the correlation between serum osteocalcin(OC)level and the secretory function of pancreaticβcells in patients with type 2 diabetes mellitus,the role of bone metabolism and its products in the pathogenesis of diabetes mellitus is explored.Methods A total of 680 patients treated in General Hospital of Northern Theater Command from January 2018 to December 2022 were selected.All the patients were divided into four groups according to OC quartile level.Basic information and biochemical indexes of patients were collected in detail.All subjects underwent 75 g oral glucose tolerance test(OCTT)and insulin release test to detect islet function,and the hormone levels at all times,βcell function index(HOMA-β),area under the C-peptide curve in 180 minutes(AUC_(cp180)),area under the glucose curve(AUC_(pc))and C-peptide secretion index were compared among the four groups.Correlation analysis was conducted by Pearson correlation analysis and linear regression after multi-factor correction.Results Through the comparative analysis of baseline data and hormone levels in different phases,it was shown that with the increase of OC level,insulin and Cpeptide secretion in different phases of the four groups were observed to be on the rise,while blood glucose and glycosylated hemoglobin were on the decline.Pearson correlation analysis showed that Ln-OC was positively correlated with Ln-HOMA-β,Ln-AUCcpiso and Ln-C-peptide secretion index,and Ln-OC was negatively correlated with HbAlc and Ln-AUC_(PG)(P<0.05).The results of partial correlation analysis after adjusting for confounding factors were consistent with the above.Simple linear regression and multiple linear regression analysis results of Ln-HOMA-βand Ln-AUC_(PG)as dependent variables showed:Ln-OC(β_(1)=0.141,β_(2)=0.113,β_(3)=0.090;β_(1)=-0.179,β_(2)=-0.191,β_(3)=-0.100),P<0.05。Conclusions Serum osteocalcin level is correlated with islet beta cell function in patients with type 2 diabetes.Osteocalcin is a protective factor of islet beta cel

关 键 词：2型糖尿病 骨钙素 胰岛Β细胞 功能 

分 类 号：R587.1[医药卫生—内分泌]