血清骨钙素水平与绝经后女性2型糖尿病患者骨密度的关系

目的:探讨血清骨钙素水平与绝经后女性2型糖尿病(type 2 diabetes,T2DM)患者骨密度(bone minaral density,BMD)间的关系。方法:本研究为回顾性分析,共纳入505例绝经后女性,其中T2DM住院患者305例,非糖尿病对照者200例,采用双能X线骨密度仪(DXA)检测腰椎(第2至第4腰椎)、股骨颈和全髋的BMD,同时检测血清骨钙素(osteocalcin,OC)水平。结果:与正常对照组相比,T2DM组患者的血清OC水平显著降低(P<0.05),腰椎、股骨颈、全髋的BMD及体质量指数显著增高(P<0.01)均呈显著负相关;校正年龄、体质量指数和糖尿病病程后,血清OC水平与腰椎及全髋的BMD间仍存在明显的负相关。结论:血清OC水平与绝经后女性T2DM患者腰椎及全髋的BMD密切相关,随着OC水平的升高,BMD呈下降趋势,提示血清OC水平可作为早期筛查绝经后女性T2DM患者骨质疏松的生化指标,结合血清OC水平和BMD能更好地预测绝经后女性T2DM患者的骨质疏松和骨折的风险。

Relationship between serum osteocalcin and bone mineral density in postmenopausal women with type 2 diabetes mellitus

Objective： To investigate the relationship between serum level of osteocalcin （OC） and bone mineral density （BMD） in postmenopausal women with type 2 diabetes mellitus （T2DM）. Methods： A total of 505 postmenopausal women aged （61±7）years were enrolled,including 305 subjects with T2DM and 200 without diabetes served as controls. Serum concentration of OC was determined, and BMDs at lumbar spine （L2-4）, femoral neck （FN） and total hip （TH） were measured by dual-energy X-ray absorptiometry （DXA）. Results： Serum levels of OC was lower（P〈0.05）, whereas BMD （L24, FN,TH） and BMI were higher in T2DM patients than those in subjects without diabetes mellitus （P〈0.01）. Linear correla- tion analysis showed that serum OC level was negatively correlated with L24BMD （r=-0.202, P〈0.05）, TH BMD（r=-0.183, P〈0.05）, and BMI （r=-0.289, P〈0.01） in postmenopausal women with T2DM. L2zBMD and TH BMD had a negative cor- relation with serum OC level even after adjustment for age, BMI and duration of diabetes. Conclusions： Serum OC level is closely related with L2~ and TH BMD in postmenopausal women with T2DM. BMD decreases with the increase of OC level, which demonstrates that serum OC could be used as a screening biochemical indicator for osteoporosis in post- menopausal women with T2DM. A combination of serum OC level and BMD might be a better predictor for osteoporosis and risk of fracture in postmenopausal women with T2DM than when assessed only by BMD.