2型糖尿病患者血清胱抑素C、尿酸水平与骨密度的相关性分析

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (38 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探究2 型糖尿病患者血清胱抑素C、尿酸水平与骨密度的相关性，并分析影响糖尿病性骨质疏松的相关因素。方法选取2018年1月～2019年5月于郑州大学第二附属医院内分泌科就诊的228 例2 型糖尿病患者，根据世界卫生组织（WHO）骨质疏松症诊断标准分为骨量正常组（43 例）、低骨量组（87 例）、骨质疏松组（77 例）、严重骨质疏松组（21 例），收集患者的一般资料。对患者的生化指标及骨密度进行相关性分析，并探讨其可能的作用机制。结果四组患者的性别、年龄、病程、舒张压、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血磷、碱性磷酸酶、血肌酐、血尿酸、血清胱抑素C、25-羟基维生素D 及肾小球滤过率估算值、腰椎1-4（L1～4）骨密度、双侧股骨颈骨密度比较，差异有统计学意义（P＜0.05）；四组患者的体重指数、空腹血糖、糖耐量试验2 h 血糖、C 肽、血钙、血尿素氮比较，差异无统计学意义（P＞0.05）。相关性分析显示，L1～4 骨密度与血尿酸、碱性磷酸酶成正相关（r=0.334、0.443，P＜0.05）,与血磷、糖化血红蛋白、血清胱抑素C 成负相关（r=-0.224、-0.371、-0.357，P＜0.05）；左侧股骨颈骨密度与血尿酸、碱性磷酸酶成正相关（r=0.242、0.607，P＜0.05）,与血磷、糖化血红蛋白、血清胱抑素C 成负相关（r=-0.156、-0.351、-0.442，P＜0.05）；右侧股骨颈骨密度与血尿酸、碱性磷酸酶成正相关（r=0.229、0.609，P＜0.05）,与血磷、糖化血红蛋白、血清胱抑素C 成负相关（r=-0.134、-0.276、-0.414，P＜0.05）。多元线性回归分析显示，糖化血红蛋白、碱性磷酸酶、血清胱抑素C、尿酸是影响2 型糖尿病患者骨密度的相关因素（P＜0.05）。结论高水平血清胱抑素C 可能是2 型糖尿病患者患骨质疏松症的危险因素，高水平血尿酸则可能是其保护因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	穆玉晶
	李俊
	李青菊
	范梦迪

关键词 ：胱抑素C, 血清尿酸, 2 型糖尿病, 骨密度

Abstract：Objective To explore the relationship between serum cystatin C, uric acid and bone mineral density in patients with type 2 diabetes mellitus, and to analyze the related factors of diabetic osteoporosis. Methods From January 2018 to May 2019, 228 patients with type 2 diabetes treated in the Department of Endocrinology, the Second Affiliated Hospital of Zhengzhou University were selected. According to the World Health Organization (WHO) diagnosis standard of osteoporosis, they were divided into normal bone mass group (43 cases), low bone mass group (87 cases), osteoporosis group(77 cases)and severe osteoporosis group(21 cases).The general data of patients were collected.The correlation between biochemical parameters and bone mineral density was analyzed and the possible mechanism was discussed. Results There were significant differences in sex, age, course of disease, diastolic pressure, glycosylated hemoglobin, total cholesterol,triacylglycerol,high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood phosphorus, alkaline phosphatase, blood creatinine, blood uric acid, serum cystatin C, 25 hydroxyvitamin D and estimated glomerular filtration rate, lumbar spine 1-4 (L1～4) bone mineral density, bilateral femoral neck bone mineral density among the four groups (P＜0.05). There were no significant differences in body mass index、systolic blood pressure、fasting plasma glucose、2-hour postprandial glucose C-peptide、serum Ca、blood urea nitrogen among the four groups (P＞0.05). Correlation analysis showed that bone mineral density of L1～4 positively correlated with serum uric acid,alkaline phosphatase (r=0.334, 0.443; P＜0.05), negatively correlated with serum P, glycosylated hemoglobin, cystatin C(r=-0.224, -0.371, -0.357; P＜0.05); bone mineral density of the left femoral neck positively correlated with serum uric acid, alkaline phosphatase (r=0.242, 0.607; P＜0.05), negatively correlated with serum P, glycosylated hemoglobin, cystatin C (r=-0.156, -0.351, -0.442; P＜0.05)；bone mineral density of the right femoral neck positively correlated with serum uric acid、alkaline phosphatase (r=0.229, r=0.609; P ＜0.05), negatively correlated with serum P, glycated hemoglobin, cystatin C (r=-0.134, -0.276, -0.414; P＜0.05). Multiple linear regression analysis showed that glycosylated hemoglobin, alkaline phosphatase, serum cystatin C and uric acid were the related factors affecting bone mineral density in patients with type 2 diabetes mellitus (P＜0.05). Conclusion High levels of serum cystatin C may be risk factors for osteoporosis in patients with type 2 diabetes, and high blood levels of uric acid may be the protection factors.

Key words： Cystatin C Serum uric acid Type 2 diabetes mellitus Bone mineral density

基金资助:河南省医学科技攻关计划项目（2018020146）

通讯作者: 李青菊（1964-），女，硕士，主任医师，研究方向：糖尿病及其并发症的诊治

作者简介: 穆玉晶（1994-），女，郑州大学第二临床学院内科学专业2017 级在读硕士研究生，研究方向：糖尿病及其并发症的诊治

引用本文:

穆玉晶; 李俊; 李青菊; 范梦迪. 2型糖尿病患者血清胱抑素C、尿酸水平与骨密度的相关性分析[J]. 中国当代医药, 2020, 27(7): 4-8.
MU Yu-jing; LI Jun; LI Qing-ju; FAN Meng-di. Correlation analysis of serum cystatin C, uric acid and bone mineral density in patients with type 2 diabetes mellitus. 中国当代医药, 2020, 27(7): 4-8.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I7/4

[9]	王潇丽，徐丽丽，杨乃龙.尿酸对人骨髓间充质干细胞成骨分化过程中Wnt 信号通路的影响[J].中国组织工程研究，2015，19（28）：4472-4477.
[1]	Oei L，Rivadeneira F，Zillikens MC，et al.Diabetes，diabetic complications，and fracture risk[J].Curr Osteoporos Rep，2015，13（2）：106-115.
[2]	Shanbhogue VV，Mitchell DM，Rosen CJ，et al.Type 2 diabetes and the skeleton： new insights into sweet bones[J].Lancet Diabetes Endocrinol，2016，4（2）：159-173.
[3]	Adil C，Ayd1n T，Tasp1nar O，et al.Bone mineral density evaluation of patients with type 2 diabetes mellitus[J].Phys Ther Sci，2015，27（1）：179-182.
[5]	Maiuolo J，Oppedisano F，Gratteri S，et al.Regulation of uric acid metabolism and excretion[J].Int J Cardiol，2016，213：8-14.
[7]	Ezzat S，Louka ML，Zakaria ZM，et al.Autophagy in osteoporosis：relation to oxidative stress[J].J Cell Biochem，2018，9：2560-2568.
[8]	温滨红，张艳阳，赵璐，等.利拉鲁肽对糖尿病骨质疏松大鼠骨代谢、炎性反应和氧化应激的影响[J].中华骨质疏松和骨矿盐疾病杂志，2017，10（6）：550-556.
[4]	Raska IJ，Rasková M，Zikán V，et al.Body composition is associated with bone and glucose metabolism in postmenopausal women with type 2 diabetes mellitus[J].Physiol Res 2017，66（1）：99-111.
[6]	Sharma T，Islam N，Ahmad J，et al.Correlation between bone mineral density and oxidative stress in postmenopausal women[J].Indian J Endocr Metab，2015，19（4）：491-497.
[10]	Chen L，Peng Y，Fang F，et al.Correlation of serum uric acid with bone mineral density and fragility fracture in patients with primary osteoporosis：a single-center retrospective study of 253 cases[J].Int J Clin Exp Med，2015，8（4）：6291-6294.
[11]	Neer RM，Arnaud CD，Zanchetta JR，et al.Effect of parathyroid hormone （1-34） on fractures and bone mineral density in postmenopausal women with osteoporosis[J].New Engl J Med，2001，344（19）：1434-1441.
[12]	Makovey J，Macara M，Jian SC，et al.Serum uric acid plays a protective role for bone loss in pefi-and postmenopausal women：a longitudinal study[J].Bone，2013，52（1）：400-406．
[13]	Ketteler M，Block GA，Evenepoel P，et al.Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder （CKD-MBD） Guideline Update： what′s changed and why it matters [J].Kidney Int，2017，92（6）：26-36.
[14]	Rigalleau V，Lasseur C，Raffaitin C，et al.Bone loss in diabetic patients with chronic kidney disease[J].Diabet Med，2007，24（1）：91-93.
[15]	马远征，王以朋，刘强，等.中国老年骨质疏松症诊疗指南（2018）[J].中国骨质疏松杂志，2018，24（12）：1541-1567.