2型糖尿病合并微血管病变与骨转换标志物的相关性

摘要

Objective To investigate changes of bone turnover markers in patients with type 2 diabetes mellitus complicated with microalbuminuria and retinopathy.Methods A total of 301 adult patients with type 2 diabetes were selected.Among those,patients combined with microalbuminuria and (or) retinopathy were divided in the experimental group,and patients without microalbuminuria and retinopathy were divided in the control group.The differences of type Ⅰ procollagen N-terminal peptide (PINP),beta isomer C-end peptide (β-CTX),and markers of bone turnover between the two groups were compared and analyzed.Results Serum PINP was not statistically significant between two groups (P ＞ 0.05).β-CTX was significantly higher in experimental group than that in the control group (P =0.001).Correlation analysis showed that β-CTX was negatively correlated with BUN (y=-0.431,P=0.013),Cr (y=-0.602,P=0.013),UA (y=-0.538,P=0.012),and25 (OH) D3 (y=-0.703,P=0.036),but was positively correlated with HbAlc (y =0.235,P=0.030) and PTH (y =0.652,P =0.000).Conclusion In type 2 diabetes mellitus patients with microalbuminuria and retinopathy,β-CTX increased significantly,suggesting that β-CTX might be a specific marker for monitoring bone metabolism in type 2 diabetes mellitus patients with microangiopathy.%目的 探讨2型糖尿病合并微量白蛋白尿、视网膜病变患者骨转换标志物的变化.方法 选取301名成人2型糖尿病患者,将合并微量白蛋白尿和(或)视网膜病变患者作为试验组,无微量白蛋白尿和视网膜病变患者作为对照组,运用统计学分析比较两组间Ⅰ型原胶原N-端前肽(procollagentype Ⅰ N-terminal propeptide,PINP)、p-异构C-端肽(beta-isomerized C-telopeptide,β-CTX)以及相关资料的差异,并对两组骨转换标志物进行相关性分析.结果 两组间血清PINP的比较,差异无统计学意义(P＞0.05);试验组p-CTX明显高于对照组(P=0.001);相关分析显示β-CTX与BUN(γ=-0.431,P=0.013)、Cr(γ=-0.602,P=0.013)、UA(γ=-0.538,P=0.012)、25(OH) D3(γ=-0.703,P=0.036)呈负相关,与HbA1c(γ =0.235,P =0.030)、PTH(γ =0.652,P=0.000)呈正相关.结论 2型糖尿病合并微量白蛋白尿和视网膜病变时,β-CTX明显增高,认为β-CTX可能成为监测2型糖尿病微血管病变患者骨代谢变化的特异性指标.