血清Irisin、FGF-23、N-MID联合检测对老年2型糖尿病患者骨质疏松的诊断价值  

Diagnostic value of serum Irisin,FGF-23 and N-MID in elderly patients with type 2 diabetes with osteoporosis

作　　者：雷文莉 王亚妮 刘立栋 张利红 曹艳宁 李洁 LEI Wenli;WANG Yani;LIU Lidong;ZHANG Lihong;CAO Yanning;LI Jie(Department of Endocrinology,Air Force 986 Hospital,Air Force Medical University,Xi′an,Shaanxi 710054,China)

机构地区：[1]空军军医大学空军第九八六医院内分泌科,陕西西安710054

出　　处：《国际检验医学杂志》2024年第24期3026-3029,3034,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨血清鸢尾素(Irisin)、成纤维细胞生长因子23(FGF23)、N端骨钙素(N-MID)联合检测对老年2型糖尿病(T2DM)患者骨质疏松(OP)的诊断价值。方法选取2021年1月至2023年6月在该院进行治疗的120例T2DM合并OP患者作为T2DM+OP组,并将同期于该院治疗的120例单纯T2DM患者作为T2DM组。比较两组血清Irisin、FGF-23、N-MID水平,多因素Logistic回归分析T2DM患者发生OP的影响因素,受试者工作特征(ROC)曲线分析血清Irisin、FGF-23、N-MID水平对T2DM患者发生OP的诊断价值。结果T2DM+OP组FGF-23、N-MID、空腹血糖(FPG)、空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)水平高于T2DM组(P<0.05),糖尿病病程长于T2DM组(P<0.05),骨密度、血清Irisin水平低于T2DM组(P<0.05)。多因素Logistic回归分析结果显示,FGF-23、N-MID、糖尿病病程、FPG、FINS是T2DM患者发生OP的独立危险因素(P<0.05),Irisin、骨密度是T2DM患者发生OP的保护因素(P<0.05)。血清Irisin、FGF-23、N-MID三者联合诊断T2DM患者发生OP的曲线下面积(AUC)为0.886,灵敏度为90.00%,特异度为74.17%,三者联合诊断T2DM患者发生OP的AUC大于血清Irisin、FGF-23、N-MID单独诊断(Z_(联合检测-Irisin)=3.945、Z_(联合检测-FGF-23)=5.119、Z_(联合检测-N-MID)=3.778,均P<0.001)。结论T2DM合并OP患者血清FGF-23、N-MID水平升高,Irisin水平降低,三者联合对老年T2DM患者发生OP具有一定的诊断价值。Objective To explore the diagnostic value of serum Irisin,fibroblast growth factor 23(FGF23)and N-mid osteocalcin(N-MID)in the elderly patients with type 2 diabetes mellitus(T2DM)with osteoporosis(OP).Methods A total of 120 patients with T2DM combined with OP who were treated in the hospital from January 2021 to June 2023 were selected as the T2DM+OP group,and 120 patients with pure T2DM who were treated in the hospital during the same period were selected as the T2DM group.The levels of serum Irisin,FGF-23 and N-MID were compared between two groups.Multivariate Logistic regression was applied to analyze the influencing factors of OP in T2DM patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Irisin,FGF-23 and N-MID levels for the occurrence of OP in T2DM patients.Results FGF-23,N-MID,fasting plasma glucose(FPG),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C)in T2DM+OP group were obviously higher than those in T2DM group(P<0.05),course of diabetes was longer than that in T2DM group(P<0.05),and bone mineral density and serum Irisin level were lower than those in T2DM group(P<0.05).Multivariate Logistic regression analysis showed that FGF-23,N-MID,diabetes course,FPG and FINS were independent risk factors for OP in T2DM patients(P<0.05),while Irisin and bone mineral density were protective factors for OP in T2DM patients(P<0.05).The area under the curve(AUC)of the combined diagnosis of serum Irisin,FGF-23 and N-MID in T2DM patients with OP was 0.886,with sensitivity of 90.00%and specificity of 74.17%.The AUC of the combination of the three for diagnosing OP in T2DM patients was larger than that of serum Irisin,FGF-23 and N-MID alone(Z_(combination-Irisin)=3.945,Z_(combination-FGF-23)=5.119,Z_(combination-N-MID)=3.778,all P<0.001).Conclusion The serum levels of FGF-23 and N-MID in patients with T2DM combined with OP increase,while the level of Irisin decreases.The combination of the three has high diagnostic value for the occurrence of OP in eld

关 键 词：鸢尾素 成纤维细胞生长因子23 N端骨钙素 2型糖尿病 骨质疏松 

分 类 号：R446.1[医药卫生—诊断学]