摘要
目的探讨中老年2型糖尿病(type 2 diabetes,T2D)患者骨代谢指标与糖化血红蛋白(glycated hemoglobin,HbA1c)的相关性。方法回顾性分析复旦大学附属浦东医院内分泌科T2D患者共372例,均为绝经后女性或≥45岁的男性,其中男性192人,女性180人。收集患者一般资料及血脂、肝功能、肾功能、HbA1c、骨代谢指标[25-羟基维生素D、β胶原降解产物(特殊序列)(β-C-terminal telopeptide of type Ⅰ collagen,β-CTX)、骨钙素N端中分子片段(N-terminal osteocalcin,N-MID)、钙(calcium,Ca)、磷(phosphorus,P)指标]。并根据HbA1c水平分为3组进行组间比较:A组HbA1c<7.5%,B组HbA1c 7.5~8.9%,C组HbA1c≥9.0%,Pearson相关性分析探索HbA1c与骨代谢指标相关性,多元线性回归分析探索T2D患者HbA1c的影响因素。结果3组间25-羟基维生素D、β-CTX、Ca、P指标差异无统计学意义,N-MID差异有统计学意义(女性:P<0.001;男性:P=0.048)。Pearson相关性分析得出HbA1c与N-MID呈负相关(女性:r=-0.302;P<0.001;男性:r=-0.207,P=0.004),与其他骨代谢指标无相关性。多元线性回归显示调整年龄及BMI后,N-MID仍为HbA1c的影响因素(女性:β=-0.321,P<0.001;男性:β=-0.339,P<0.001)。结论在绝经后女性及中老年男性T2D患者中,血清N-MID与HbA1c呈负相关,因而血清N-MID高水平可能有助于T2D患者血糖的控制。
Objective To examine the relationship between bone metabolism biomarker and glycated hemoglobin(HbA1c)in patients with type 2 diabetes(T2D).Methods A total of 372 patients with T2D in Department of Endocrinology,Shanghai Pudong Hospital were retrospectively analyzed,all of them were post-menopausal women or men age 45 years or older,with 192 males and 180 females.General data of the patients were collected as well as blood lipid,liver function,renal function,HbA1c,bone metabolism indexes including 25-hydroxy vitamin D(25(OH)D),β-C-terminal telopeptide of type Ⅰ collagen(β-CTX),N-terminal osteocalcin(N-MID),calcium(Ca)and phosphorus(P)indexes.Patients were categorized into three groups based on the level of glycated hemoglobin(HbA1c)for inter-group comparison:group A(HbA1c<7.5%),group B(HbA1c 7.5%-8.9%),and group C(HbA1c≥9.0%).Results There were no statistically significant differences in 25(OH)D,β-CTX,Ca and P among the three groups.However,variations in N-MID(female:P<0.001;male:P=0.048)was significant.Pearson correlation analysis showed that HbA1c was negatively correlated with N-MID(female:r=-0.302;P<0.001;male:r=-0.207;P=0.004).Multiple linear regression showed that N-MID was an influencing factor of HbA1c after adjusting for age and BMI(female:β=-0.321,P<0.001;male:β=-0.339,P<0.001).Conclusion In postmenopausal women and middle-aged and elderly men with T2D,N-MID is inversely related with HbA1c,implying that a higher serum N-MID level may benefit in blood glucose control in T2D patients.
作者
刘聪颖
潘俊宏
文松
周里钢
LIU Cong-ying;PAN Jun-hong;WEN Song;ZHOU Li-gang(Department of Endocrinology,Shanghai Pudong Hospital-Pudong Medical Center,Fudan University,Shanghai 201399,China;Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling,Shanghai 201399,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2022年第5期733-738,共6页
Fudan University Journal of Medical Sciences
基金
复旦大学附属浦东医院重点学科项目(Zdxk2020-11)
上海市浦东医院重点专科项目(Zdzk2020-24)
上海市浦东新区卫健委临床高原学科项目(PWYgy2021-03)。
