中老年2型糖尿病患者血清胆碱酯酶水平与骨密度的相关性研究  

Relationship between serum cholinesterase levels and bone mineral density in middle-aged to elderly patients with type 2 diabetes mellitus

作　　者：严春雷[1] 徐峰[2] 李丹丹 赵丽华[2] 宁莉燕[3] 段程伟 张冬梅[4] 王雪琴[2] 苏建彬[2] Yan Chunlei;Xu Feng;Li Dandan;Zhao Lihua;Ning Liyan;Duan Chengwei;Zhang Dongmei;Wang Xueqin;Su Jianbin(Department of Nuclear Medicine,Second Affiliated Hospital of Nantong University,First People′s Hospital of Nantong,Nantong226001,China;Department of Endocrinology,Second Affiliated Hospital of Nantong University,First People′s Hospital of Nantong,Nantong226001,China;Department of Administration,Second Affiliated Hospital of Nantong University,First People′s Hospital of Nantong,Nantong226001,China;Medical Research Center,Second Affiliated Hospital of Nantong University,First People′s Hospital of Nantong,Nantong226001,China)

机构地区：[1]南通市第一人民医院南通大学第二附属医院核医学科,南通226001 [2]南通市第一人民医院南通大学第二附属医院内分泌科,南通226001 [3]南通市第一人民医院南通大学第二附属医院行政办公室,南通226001 [4]南通市第一人民医院南通大学第二附属医院临床医学研究中心,南通226001

出　　处：《中华糖尿病杂志》2025年第1期140-147,共8页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：南通市科技局科研项目(MS12019019,JC12022045,MS2023083)。

摘　　要：目的探讨中老年2型糖尿病(T2DM)患者血清胆碱酯酶(ChE)水平与骨密度是否存在相关性。方法该研究为横断面研究。选取2020年12月至2023年12月于南通市第一人民医院内分泌科就诊的中老年T2DM患者(男性≥55岁及绝经后女性)作为研究对象。收集研究对象身高、体重并计算体重指数(BMI);检测其血清ChE水平、白蛋白、空腹C肽、血红蛋白、糖化血红蛋白(HbA 1c),以及骨钙素、Ⅰ型前胶原氨基端前肽(P1NP)和β-Ⅰ型胶原交联羧基末端肽(β-CTX)等骨转化标志物;测量研究对象腰椎、股骨颈、全髋和全身的骨密度。按照ChE中位数值8.20 kU/L将研究对象分为低水平ChE组(血清ChE为3.72~8.20 kU/L)和高水平ChE组(血清ChE为8.21~15.38 kU/L)。采用两样本独立t检验、Mann-Whitney U检验或卡方检验来检验相关指标在两组间的差异,采用Pearson相关性分析法来分析血清ChE水平与相关指标之间的相关性,采用多因素线性回归分析法分析血清ChE水平是否为患者各部位骨密度的独立影响因素。结果共纳入668例中老年T2DM患者,其中低水平ChE组335例,高水平ChE组333例。与低水平ChE组相比较,高水平ChE组腰椎、股骨颈、全髋和全身的骨密度均更高(P<0.001)。Pearson相关性分析结果显示,血清ChE水平与腰椎骨密度、股骨颈骨密度、全髋骨密度和全身骨密度均呈正相关(r值分别为0.182、0.271、0.289和0.165,P均<0.001)。通过多因素线性回归分析校正了BMI、白蛋白、空腹C肽、血红蛋白、HbA 1c和骨转换标志物(骨钙素、P1NP和β-CTX)等临床指标后,血清ChE升高仍是腰椎骨密度(β=0.146,t=3.077,P=0.003)、股骨颈骨密度(β=0.186,t=4.409,P<0.001)、全髋骨密度(β=0.171,t=4.104,P<0.001)和全身骨密度(β=0.116,t=2.738,P=0.006)升高的独立影响因素。结论血清ChE水平与骨密度呈正相关,是中老年T2DM患者骨密度升高的独立影响因素。ObjectiveTo investigate whether there was a correlation between serum cholinesterase(ChE)levels and bone mineral density in middle-aged to elderly patients with type 2 diabetes mellitus(T2DM).MethodsThis was a cross-sectional study.Middle-aged to elderly T2DM patients(males≥55 years old and postmenopausal females)were recruited for this study at the Department of Endocrinology of Nantong First People′s Hospital between December 2020 and December 2023.The height and weight of the subjects were collected to calculate their body mass index(BMI);serum ChE levels,albumin,fasting C-peptide,hemoglobin,glycated hemoglobin A 1c(HbA 1c)and bone turnover biomarkers(BTM),including osteocalcin,β-crosslaps(β-CTX)and total procollagen-1 N-terminal peptide(P1NP),were measured;the bone mineral density of various regions was assessed by dual-energy X-ray absorptiometry(DXA)in all subjects,including the lumbar,femoral neck,hip,and whole body.All subjects were divided into two subgroups according to the median serum ChE level(8.20 kU/L):the low-level ChE group(range of ChE,3.72-8.20 kU/L)and the high-level ChE group(range of ChE,8.21-15.38 kU/L).The two-sample independent t-test,the Mann-Whitney U test,or the chi-squared test was used to analyze the differences between the two subgroups;Pearson′s correlation analysis was used to analyze the relationship between ChE and related clinical variables;and multivariate linear regression analysis was used to analyze whether ChE was an independent factor for bone mineral density in various regions of the body.ResultsA total of 668 middle-aged to elderly T2DM patients were included,with 335 patients in the low-level ChE group and 333 patients in the high-level ChE group.Compared to the low-level ChE group,the high-level ChE group had greater lumbar,femoral neck,hip and whole-body bone mineral density(P<0.01).Pearson′s correlation analysis revealed that the serum ChE levels were positively correlated with the lumbar,femoral neck,hip and whole-body bone mineral density(r=0.182,0.271,0

关 键 词：糖尿病 2型 胆碱酯酶 骨密度 

分 类 号：R587.1[医药卫生—内分泌]