摘要
目的探讨代谢健康型肥胖(MHO)青年男性骨代谢标志物及骨密度水平及其与代谢相关指标的相关性。方法根据体质指数及相关检测结果,将99例青年男性分为正常组32例、代谢健康型超重组37例、MHO组30例。比较3组研究对象糖脂代谢指标、血压、骨代谢标志物水平及骨密度,分析骨代谢标志物及骨密度水平与代谢相关指标的相关性。结果3组研究对象Ⅰ型前胶原氨基端前肽(PⅠNP)、骨钙素、L1~L4骨密度、股骨颈骨密度及全身骨密度差异无统计学意义(均P>0.05),而MHO组和代谢健康型超重组的体质指数、空腹血糖、餐后2 h血糖(2hPBG)、稳态模型评估胰岛素抵抗(HOMA-IR)指数、三酰甘油水平高于正常组,而HDL-C水平低于正常组,MHO组Ⅰ型胶原交联C末端肽(CTX)水平高于正常组(均P<0.05)。Pearson相关性分析显示,3组研究对象PⅠNP与空腹血糖呈负相关,CTX与空腹血糖、体质指数、HOMA-IR指数呈正相关,与HDL-C呈负相关;骨钙素与体质指数、空腹血糖、2hPBG、HOMA-IR指数呈负相关(均P<0.05),与HDL-C呈正相关(均P<0.05);全身骨密度与体质指数呈正相关(P<0.05)。多元线性回归分析结果显示,3组研究对象体质指数与CTX呈正相关而与骨钙素呈负相关,空腹血糖与PⅠNP及骨钙素均呈负相关(P<0.05)。结论MHO青年男性的腰椎、股骨颈及全身骨密度并未随体质指数的增加而改变,但MHO青年男性的CTX水平升高,且其骨钙素与体质指数、空腹血糖、2hPBG及HDL-C等多个糖脂代谢指标相关,提示肥胖及糖脂代谢异常人群均存在骨量流失的风险。
Objective To explore the levels of bone metabolism markers and bone mineral density and their correlation with metabolism-related indices in young metabolically healthy but obese(MHO)males.Methods Ninety-nine young males were divided into normal group(32 cases),metabolically healthy but overweight group(37 cases),and MHO group(30 cases)according to their body mass index(BMI)and relevant detection results.The subjects′levels of glycolipid metabolism indices,blood pressure and bone metabolism markers,as well as bone mineral density were compared among the three groups,and the correlation of bone metabolism markers and bone mineral density levels with metabolism-related indices was analyzed.Results No statistically significant differences were found among the three groups in procollagen typeⅠN-terminal propeptide(PⅠNP),osteocalcin,bone mineral density in L 1-L 4,bone mineral density in neck of femur,or whole-body bone mineral density(all P>0.05),however,the MHO group and the metabolically healthy overweight group had higher levels of BMI,FBG,2-hour postprandial blood glucose(2hPBG),homeostasis model assessment-insulin resistance(HOMA-IR)index and TG,and a lower HDL-C level as compared with the normal group,the MHO group had a higher level of typeⅠcollagen cross-linked C-telopeptide(CTX)than the normal group(all P<0.05).Pearson correlation analysis revealed that,among the three groups,PⅠNP negatively correlated with FBG,CTX positively correlated with FBG,BMI and HOMA-IR index,and negatively correlated with HDL-C;osteocalcin negatively correlated with BMI,FBG,2hPBG and HOMA-IR index(all P<0.05),and positively correlated with HDL-C(all P<0.05);whole-body bone mineral density positively correlated with BMI(P<0.05).Multiple linear regression analysis results showed that,among the three groups,BMI positively correlated with CTX,and negatively correlated with osteocalcin,FBG negatively correlated with PⅠNP and osteocalcin(P<0.05).Conclusion Young MHO males never present BMI-dependent changes in lumbar,neck of femur,or whole-body bone mineral density,but experience an elevated CTX level,furthermore,their osteocalcin correlates with BMI,FBG,2hPBG,HDL-C and a couple of glycolipid metabolism indices,indicating individuals with obesity or glycolipid metabolism anomaly are at a risk of osteopenia.
作者
刘俊茹
尹福在
吴广飞
王迪
王星
范冬梅
刘博伟
LIU Jun-ru;YIN Fu-zai;WU Guang-fei;WANG Di;WANG Xing;FAN Dong-mei;LIU Bo-wei(Department of Endocrinology,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China)
出处
《广西医学》
CAS
2019年第15期1883-1887,共5页
Guangxi Medical Journal
基金
河北省省级科技计划(162777116D)
关键词
肥胖
代谢健康
Ⅰ型前胶原氨基端前肽
Ⅰ型胶原交联C末端肽
骨钙素
骨密度
糖代谢
脂代谢
青年
男性
Obesity
Metabolic health
Procollagen typeⅠN-terminal propeptide
TypeⅠcollagen cross-linked C-telopeptide
Osteocalcin
Bone mineral density
Glycometabolism
Lipid metabolism
Youth
Male
