2型糖尿病患者骨转换标志物与骨密度的相关性研究

目的探讨骨转换标志物在2型糖尿病合并骨质疏松患者中的临床应用价值及与不同部位骨密度的相关关系。方法选择我院64例2型糖尿病成年男性患者为病例组，同期收集20例健康成年男性为对照组，用双能X线吸收测定仪检测受试者正位腰椎（L1-L4）、右侧髋部（股骨颈、大转子、ward’s三角）的骨密度，并依据WHO骨质疏松症诊断标准将病例组分为骨质疏松组、骨量减少组、骨量正常组。同时检测血清骨钙素（osteocalcin，OC）、总Ⅰ型前胶原氨基端延长肽（procollagen type Ⅰ N—terminal propeptide，PINP）、Ⅰ型胶原羧基端肽β特殊序列（β—carboxy—terminal collagen crosslinks，β—CTX）、血钙（calcium，Ca）、血磷（phosphorus，P）、甲状旁腺素（parathyroid hormone，PTH）、25羟维生素D3[25-hydroxy vitamin D3，25（OH）D3]、空腹血糖（fasting blood—glucose，FBG）、糖化血红蛋白（hemoglobin AlC，HbAlC）、碱性磷酸酶（alkaline phosphatase，ALP）以及血清肌酐（serum creatinine，SCr）等临床化学指标，对检测结果进行统计学分析。结果各组间年龄、体重指数差异均无统计学意义（P均〉0．05）。骨量减少组及骨质疏松组的脊椎骨密度值、髋部骨密度值均显著低于健康对照组，且差异均有统计学意义（P均〈0．05）；骨量减少组与健康对照组相比，SCr、FBG、HbAlC和β—CTX均升高，差异均有统计学意义（P均〈0．05）；骨质疏松组与健康对照组相比，SCr、ALP、FBG、HbAlC、PINP、β—CTX、PTH结果均升高，且差异具有统计学意义（P均〈0．05）；骨量减少组和骨质疏松组的25（OH）D，均明显降低，与健康对照组相比差异均有统计学意义（P均〈0．05）。相关性分析结果表明，PINP、β—CTX与大转子、股骨全部的骨密度均呈负相关（P均〈0．05）。结论骨转换标志物与骨密度联合检测能更早反映糖尿病患?

Relationship research of biochemical marker of bone turnover and bone mineral density in type 2 diabetes patients

Objective To investigate the clinical value of biochemical marker of bone turnover in type 2 diabetes combined osteoporosis, and to find the relationship between biochemical marker of bone turnover and bone mineral density. Methods 64 cases adult males with type 2 diabetes and 20 cases healthy adult males were collected. The bone mineral density of lumbar vertebrae （L1-L4） and light huckle of all the subjects were measured by dual-energy X-ray absorptiometry. The patients were divided into osteoporosis group, osteopenia group and non- osteoporosis group according to the WHO diagnostic criteria of osteoporosis. The levels of osteocalcin （OC）, procollagen type Ⅰ N-terminal propeptide （PINP）, β-carboxy-terminal collagen crosslinks （β-CTX）, calcium （Ca）, phosphorus （P）, parathyroid hormone （PTH）, 25-hydroxy vitamin D3 [25 （OH）D3], fasting blood-glucose （FBG）, hemoglobin AlC （HbAlC）, alkaline phosphatase （ALP） and serum creatinine （SCr） were detected. The results were analyzed statistically. Results There were no statistical significance in the differences of age and body mass index among all the groups （Pall〉 0.05 ）. The bone mineral density levels of lumbar vertebrae （L1-L4） and light huckle in osteoporosis group and osteopenia group were all lower than that of control group, and the differences all had statistical significance （Pall〈 0.05 ）. There were statistical significance in the differences of β-CTX, SCr, HbAlC and FBG levels between osteopenia group and control group （Pall 〈 0.05）. There were statistical significance in the differences of SCr, ALP, FBG, HbAlC, PINP,β-CTX and PTH levels between osteoporosis group and control group （Pall〈 0.05 ）. The levels of 25 （OH）D3 in osteopenia group and osteoporosis group were all lower than that of control group, and the differences aU had statistical significance （Pall〈 0.05）. Correlation analysis results showed that both PINP and β- CTX were negatively correlated with the bone