摘要
目的探讨2型糖尿病患者血清尿酸(SUA)与高密度脂蛋白(LDL-C)的比值(UHR)与骨代谢、骨密度和骨质疏松的相关性。方法选择2021年6—12月在青岛市即墨区人民医院内分泌科住院的371例2型糖尿病患者(T2DM)。收集一般临床资料、甲状腺激素(PTH)、血清总I型前胶原N-末端前肽(P1NP),骨钙素N端中分子片段(N-MID OC)、I型胶原交联C-末端肽(β-CTX),总25羟基维生素D[25-(OH)D]。双能X线吸收法测定腰椎(LV)1~4,股骨头(FH)、股骨颈(FN)的骨密度(BMD)。将血清尿酸与高密度脂蛋白比值(UHR)三分位法分层比较腰椎、股骨头和股骨颈骨密度与N-MID OC、PTH、β-CTX、P1NP、25-(OH)D的相关性。Logistic回归分析UHR与骨质疏松的关系。结果一般资料比较:男性的N-MID OC、PINP、β-CTX、TG、TC、HDL-C、HbA1c均低于女性,男性的25-(OH)D、骨密度和SUA均高于女性,差异有统计学意义(P<0.05)。UHR3组的LV、FH、FN骨密度和SUA、TG显著高于UHR1组和UHR2组,HDL-C、HbA1c、TC、LDL-C显著低于UHR1组和UHR2组,差异有统计学意义(P<0.05)。UHR3组和UHR2组的β-CTX显著低于UHR1组,UHR3组的PTH显著高于UHR1组,差异有统计学意义(P<0.05)。Pearson相关分析显示UHR与PTH、LV BMD、FN BMD、FH BMD呈正相关,与β-CTX呈负相关(P<0.05),与25-(OH)D、N-MID OC和P1NP无相关性(P>0.05)。以T2DM合并骨质疏松为因变量,多因素Logistic回归显示,调整年龄、性别、BMI、HbA1c、TG、LDL-C后,UHR是T2DM患者发生骨质疏松的保护因素。结论在2型糖尿病患者中,正常偏高的UHR可能减少骨质疏松的发生风险。
Objective To investigate the correlation of serum uric acid(SUA)to high-density lipoprotein(LDL-C)ratio(UHR)with bone metabolism,bone mineral density and osteoporosis in patients with type 2 diabetes.Methods A total of 371 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Endocrinology Department of Jimo District People's Hospital in Qingdao from June to December 2021 were selected.Collected general clinical data,thyroid hormone(PTH),serum total type I procollagen N-terminal propeptide(P1NP),osteocalcin N-terminal middle molecular fragment(N-MID OC),type I collagen cross-linked C-terminal peptide(β-CTX),total 25-hydroxyvitamin D[25-(OH)D].Bone mineral density(BMD)of lumbar spine(LV)1-4,femoral head(FH)and femoral neck(FN)was determined by dual energy X-ray absorptiometry.Correlation of lumbar spine,femoral head and femoral neck BMD with N-MID OC,PTH,β-CTX,P1NP,25-(OH)D by stratifying the serum uric acid to high-density lipoprotein ratio(UHR)tertiles sex.Logistic regression analysis of the relationship between UHR and osteoporosis.Results Comparison of general data:Men's N-MID OC,PINP,β-CTX,TG,TC,HDL-C and HbA1c were lower than women's.The 25-(OH)D,BMD and SUA of males were higher than those of females,and the difference was statistically significant(P<0.05).The LV BMD,FH BMD,FN BMD,SUA and TG of UHR3 group were significantly higher than those of UHR1 group and UHR2 group.The HDL-C,HbA1c,TC,and LDL-C were significantly lower than those of the UHR1 and UHR2 groups,and the difference was statistically significant(P<0.05).Theβ-CTX of UHR3 group and UHR2 group was significantly lower than that of UHR1 group,and the PTH of UHR3 group was significantly higher than that of UHR1 group,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that UHR was positively correlated with PTH,LV BMD,FN BMD,FH BMD,negatively correlated withβ-CTX(P<0.05),and had no correlation with 25-(OH)D,N-MID OC and P1NP(P>0.05).Taking T2DM complicated with osteoporosis as the dependent variable,multivariate Logistic regression showed that after adjusting for age,gender,BMI,HbA1c,TG,and LDL-C,UHR was a protective factor for osteoporosis in T2DM patients.Conclusion In patients with type 2 diabetes mellitus,a high normal UHR may reduce the risk of osteoporosis.
作者
相爱霞
宋勇刚
于婷婷
王小燕
史莎莎
吕淑云
傅晓倩
陈丰霞
XIANG Aixia;SONG Yonggang;YU Tingting;WANG Xiaoyan;SHI Shasha;LYU Shuyun;FU Xiaoqian;CHEN Fengxia(Department of Endocrinology,People's Hospital of Jimo District,Qingdao,Shandong Province,266200 China)
出处
《糖尿病新世界》
2022年第12期26-30,共5页
Diabetes New World Magazine
关键词
2型糖尿病
血尿酸/高密度脂蛋白比值
骨代谢
骨密度
骨质疏松
Type 2 diabetes
Serum uric acid/high density lipoprotein ratio
Bone metabolism
Bone mineral density
Osteoporosis
