糖尿病患者血清骨钙素水平的改变及其临床意义

糖尿病患者血清骨钙素水平的改变及其临床意义陶少平，陈凌，徐德凤，孔祥辉糖尿病性骨质疏松的确切病理机制至今仍不十分清楚。近年来，骨钙素（ＢＧＰ）成为更敏感的成骨细胞活性指标。为探讨糖尿病性骨质疏松的发病机理，我们对６６例糖尿病病人的血清骨钙素和其他骨代...     

氟骨症患者的血清骨钙素测定

氟骨症患者的血清骨钙素测定梁君慧，陈丽佳，张勋堂，梅玉芝，郭平，李东喜，张世和，游友臣，常树军，郑文保选择经Ｘ线摄片确诊氟骨症患者３１名，正常对照４１名．观察血清骨钙素（ＢＧＰ）水平，并对其发生机制作初步探讨。资料和方法１．对象选择：新疆石河于地区１...     

维族百岁老人口腔状况与血清骨钙素检测观察

我们于１９９６年６月对４４名维吾尔族（以下简称维族）百岁老人血清骨钙素进行检测，现将其与口腔状况关系的观察结果报道如下。一、对象与方法１．对象：均为世居新疆维吾尔族自治区和田、于田、策勒等县农村的维族农民（百岁组、老年组），近２周内无服药史、疾病史、...     

血液透析患者血清肌钙蛋白T检测的临床研究

目的　观察维持性血液透析患者血清肌钙蛋白T(cTnT)与原发病、心血管事件及死亡事件的关系。　方法　对 5 7例维持性血液透析患者采用干化学方法测定血清cTnT水平 ,随访 1年。　结果　 5 7例患者中cTnT升高者 12例 ,死亡 7例 ,4例 (33 3% )死于急性左心衰 ,12例中有 8例原发病为糖尿病 ;cTnT正常者 4 5例 ,死亡 3例 ,1例 (2 2 % )死于心血管事件 ,两组比较差异有显著性 (P <0 0 0 1)。 2 4例患者测定了透析前后cTnT浓度 ,其中 6例透析前cTnT升高者 ,透析后有 5例cTnT仍进一步升高 ,1例下降但高于 0 1μg/L。　 结论　部分血液透析患者血清cTnT水平升高 ,原发病为糖尿病肾病的患者其发生率高 ,cTnT升高与急性心肌梗死无明确关系 ,但与血液透析患者死亡率及伴发心血管疾病有密切正相关关系 ,血液透析本身对cTnT无影响。     

2型糖尿病患者强化治疗前后血清骨钙素的变化

目的了解2型糖尿病（Type2 diabetes T2DM）患者在严格控制血糖后血清骨钙素（Osteocalcin,OC）水平的变化及其影响因素。方法按1999年WHO诊断标准筛选T2DM患者44例,应用胰岛素泵强化治疗12～15天,同时给予调脂、降压等综合治疗。记录人体测量参数,计算体质量指数（Body mass index,BMI）、腰臀比（Waist-to-hip ratio,WHR）,监测治疗前、后生化指标,以及空腹血清OC、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）、白介素-6（interleakin-6,IL-6）的变化。结果强化治疗后血清OC水平由（7．624±3．23）ns／L上升至（11．92±4．45）ng／L,有显著意义（P〈0．01）。Pearson相关分析显示,治疗前后血清骨钙素的增值（AOC）与WHR（r=-0．339,P=0．024）、A空腹血糖（Fasting plasma glucose,FPG r=-0．890,P=0．000）、△餐后两小时血糖（2hour post-meal blood glucose,2h PBG r=-0．364,P=0．015）、△超敏C反应蛋白（high-sensitivity C—reaction protein,hs-CRP r=-0．372,P=0．013）以及△IL-6（r=-0．334,P=0．027）成负相关。多元逐步回归分析显示,△FPG是影响△OC的独立相关因素。结论T2DM患者强化治疗后血清OC水平比治疗前显著升高,且其增值与△FPG水平呈负相关,揭示了体内骨代谢与能量代谢之间存在密切关系。     

维持性血液透析患者血清铁蛋白与动脉粥样硬化的相关性分析

目的探讨维持性血液透析（MHD）患者血清铁蛋白（SF）与动脉粥样硬化（AS）的关系。方法选择透析龄〉12月的MHD患者62例和健康对照者60例,应用高分辨二维超声测量受试者颈动脉内-中膜厚度（IMT）及粥样硬化斑块,并同时行SF、C反应蛋白（CRP）、血脂及其他生化指标检测。结果MHD组IMT、IMT增厚阳性率、斑块阳性检出率、SF及LDLC水平均显著高于对照组（P〈0．05）;MHD伴AS组与无AS组比较,SF水平明显升高（P〈0．01）,年龄、LDLC及年注射静脉铁剂量显著高于非AS组（P〈0．05）。多元线性回归分析显示,影响颈动脉IMT增厚的风险因素有高龄、高SF、年注射静脉铁剂量和高LDLC水平（P〈0．05）;直线相关分析发现SF与IMT、LDLC水平呈正相关（r=0．294,P〈0．01;r=0．311,P〈0．05）。结论MHD患者血清SF、LD—LC均明显高于对照组;高龄、血清SF水平增高、年注射静脉铁剂剂量增加是加重MHD患者AS发生、发展的高危因素。     

肺结核病人血清骨钙素含量测定

本文采用放射免疫分析法，对６０例肺结核患者治疗前、后及３０例健康人的血清进行了骨钙素含量的测定，结果：肺结核组治疗前血清ＢＧＰ含量与健康人相比有显著差异（Ｐ＜０．０１）；治疗后血清ＢＧＰ较治疗前明显上升（Ｐ＜０．０１）。     

肝硬化患者血清透明质酸的变化及其意义

血清透明质酸(HA)作为慢性肝病进入肝硬化期的检测指标,国内外虽有不少报道,但结果不甚一致。本文报告了42例肝硬化病人的的血清 HA 及常规肝功能检测结果,分析了血清 HA 与常规肝功能的关系。对象与方法一、检测对象:42例病人均根据病史、体检、常规生化、B 超检查而确诊为肝硬化病人。清晨空腹采集分离血清,测定常规项目及HA。二、方法:血清 HA 用放射分析法测定,选用上海第二军医大学长征医院和上海海军     

骨钙素及其临床意义

骨钙素(osteocalcin),亦称γ-羧基谷氨酸蛋白(bone γ-carboxyglutamic acid-containing protein,BGP)和骨依赖维生素K蛋白(bone vitamin K dependent protein)。它是由成骨细胞产生和分泌的一种非胶原蛋白,具有骨代谢调节激素的作用。骨钙素不仅对骨生长、代谢具有重要意义,同时在一些内分泌疾病的诊断和发病中具有一定作用。     

糖尿病血清骨钙素水平与临床

本分析８３例糖尿病患骨钙素与碱性磷酸酶、钙、磷、雌二醇各参数的变应关系,结果显示：男性呈低ＢＧＰ,女性表现为你雌二醇与高ＢＧＰ,两组钙磷比例失调,提示糖尿病患骨吸收增强。     

长期血液透析和腹膜透析患者血脂水平及其相关因素分析

目的：观察血液透析和腹膜透析对终末期肾衰竭患者血脂的影响及相关因素。方法：血透患者36例，腹透(CAPD)患者25例，对照组35例，分别检测开始透析时及透析后12个月时的血脂、血浆白蛋白、血清肌酐(Scr)水平。结果：腹透组患者12个月后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、载脂蛋白B(ApoB)及脂蛋白(a)[Lp(a)]较透析前明显增高，HDL-C、ApoA1较透析前明显降低；血透组患者12个月后HDL-C明显降低；二组患者透析前ApoA1明显低于对照组，ApoB、Lp(a)明显高于对照组，二组患者透析前均有明显的低蛋白血症，透析后血浆白蛋白明显降低，腹透患者尤其显著。血浆白蛋白水平与血脂呈显著相关。结论：尿毒症患者透析前即存在血脂异常，透析治疗并不能消除高脂血症，甚至加重高脂血症，以腹透患者明显。营养不良、低蛋白血症是透析患者高脂血症的主要致病因素。     

Decreased serum undercarboxylated osteocalcin is associated with cognitive impairment in male patients with type 2 diabetes

Background

Basic and clinical researches have suggested that type 2 diabetes (T2DM) is associated with cognitive impairment, and diabetes mellitus increases the risk of cognitive impairment and dementia. Recently, some reports found that undercarboxylated osteocalcin (ucOC) could affect brain functions, and decreased in patients with T2DM. We aimed to investigate the association of serum ucOC with cognitive impairment in T2DM patients.

Hemocholecyst complicated in a hemodialysis patient with microscopic polyangiitis

Microscopic polyangiitis (MPA) is a systemic vasculitis associated with antineutrophil cytoplasmic antibodies, and it involves multiple organs, including the kidneys and lungs. We report on the case of a 72-year-old woman with MPA who developed hemocholecyst in addition to alveolar hemorrhage and rapidly progressive glomerulonephritis. Although her renal function was not salvaged, the alveolar hemorrhage and hemocholecyst were treated conservatively. Clinicians should consider the possibility of hemocholecyst in patients with MPA complaining of abdominal pain.     

Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: A meta-analysis

Background and aimsStudies have shown inconsistent results about the association between serum uric acid (SUA) levels and mortality in hemodialysis patients. We performed this meta-analysis to determine whether higher SUA values comprised a risk factor of cardiovascular or all-cause mortality in maintenance hemodialysis patients.Methods and resultsPubmed, Embase and the Cochrane library were searched up to August 31, 2020 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in maintenance hemodialysis patients. Pooled adjusted hazard ratios (HR) and corresponding 95% confidence interval (CI) were calculated using a random-effects model. We included 10 studies with an overall sample of 264,571 patients with hemodialysis in this meta-analysis. Patients with the highest SUA were associated with a decreased risk of cardiovascular mortality (HR = 0.72, 95% CI 0.59–0.87) compared with patients with the lowest SUA after adjustment for potential confounders in a random effects model. Moreover, for each increase of 1 mg/dl of SUA, the overall risks of all-cause and cardiovascular mortality decreased by 6% and 9%, respectively (HR = 0.94, 95% CI 0.90–0.99; HR = 0.91, 95% CI 0.89–0.94).ConclusionElevated SUA levels are strongly and independently associated with lower risk of cardiovascular mortality in maintenance hemodialysis patients. More designed studies, especially randomized controlled trials, should be conducted to determine whether high SUA levels is an independent risk factor of all-cause mortality in hemodialysis patients.     

血清骨钙素水平与肺癌骨转移相关性的临床研究

目的探讨血清骨钙素水平与肺癌骨转移的关系。方法采用放射免疫分析法（R IA）分别对原发性肺癌和正常人血清骨钙素水平进行检测,然后再通过核素全身骨显像扫描方法将肺癌患者分为骨转移患者和非骨转移患者。结果肺癌骨转移组血清钙素水平显著高于肺癌无骨转移组和正常组（P〈0.05）,并且血清钙素水平与肺癌骨转移病灶数目呈正相关;不同细胞类型肺癌血清骨钙素水平差异无统计学意义（P〉0.05）。结论肺癌发生骨转移时,伴随着血清钙素水平的提高,因此血清钙素水平的检测,可用于肺癌骨转移的诊断。     

Use of etanercept in a patient with rheumatoid arthritis on hemodialysis

Abstract

Disease-modifying anti-rheumatic drugs (DMARDs) are typically used for the therapy of rheumatoid arthritis (RA), but most have some nephrotoxicity. In several clinical studies, etanercept had fewer adverse effects on renal function than other DMARDs. We report the case of a 64-year-old woman with RA and renal insufficiency on hemodialysis treated using etanercept therapy. This case suggests that etanercept therapy might be effective in the short term for such patients.     

Serum osteocalcin concentrations in patients with multiple myeloma--correlation with disease stage and survival.

Multiple myeloma affects bone, and enhanced bone resorption is a characteristic finding. In the present study the serum concentration of osteocalcin, serum bone gla-protein, which is a protein specific for bone turnover and reflects osteoblast activity, was analysed at diagnosis in 48 patients with multiple myeloma. At that time there was a significant relationship between disease stage (Durie-Salmon) and osteocalcin levels, lower levels being found in patients with more advanced disease. No relationship was found between osteocalcin and serum calcium levels. To date, 33 patients have died. There was a significant correlation between initial osteocalcin levels and patient survival. These findings suggest that serum osteocalcin could be a marker of prognostic significance for survival in multiple myeloma.     

Use of etanercept in a patient with rheumatoid arthritis on hemodialysis

Disease-modifying anti-rheumatic drugs (DMARDs) are typically used for the therapy of rheumatoid arthritis (RA), but most have some nephrotoxicity. In several clinical studies, etanercept had fewer adverse effects on renal function than other DMARDs. We report the case of a 64-year-old woman with RA and renal insufficiency on hemodialysis treated using etanercept therapy. This case suggests that etanercept therapy might be effective in the short term for such patients.