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血清骨钙素水平与2型糖尿病患者的糖代谢及动脉粥样硬化参数相关。

Serum osteocalcin level is associated with glucose metabolism and atherosclerosis parameters in type 2 diabetes mellitus.

作者信息

Kanazawa Ippei, Yamaguchi Toru, Yamamoto Masahiro, Yamauchi Mika, Kurioka Soichi, Yano Shozo, Sugimoto Toshitsugu

机构信息

Department of Internal Medicine 1, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.

出版信息

J Clin Endocrinol Metab. 2009 Jan;94(1):45-9. doi: 10.1210/jc.2008-1455. Epub 2008 Nov 4.

Abstract

CONTEXT

Recent animal studies showed that osteocalcin action is related to not only bone metabolism but also glucose metabolism and fat mass. We investigated the relationship between two bone formation markers, serum osteocalcin and bone-specific alkaline phosphatase, and glucose metabolism, serum adiponectin, and the amount of fat mass as well as atherosclerosis parameters in men and postmenopausal women with type 2 diabetes.

METHODS

A total of 179 men and 149 postmenopausal women were recruited consecutively, and radiographic and biochemical characteristics were collected. Brachial-ankle pulse wave velocity (baPWV) and intima-media thickness (IMT) were evaluated as the parameters of atherosclerosis.

RESULTS

Multiple regression analysis adjusted for age, duration of diabetes, body mass index, and serum creatinine showed that osteocalcin negatively correlated with fasting plasma glucose and hemoglobin A(1c) in both men and postmenopausal women (P < 0.05) and with percent fat, baPWV, and IMT in men (P < 0.05). Osteocalcin positively correlated with total adiponectin in postmenopausal women (P < 0.001). After additional adjustments for systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, hemoglobin A(1c), and Brinkmann index, osteocalcin still significantly and negatively correlated with baPWV and IMT in men. In contrast, osteocalcin did not correlate with fasting C-peptide, and bone-specific alkaline phosphatase did not correlate with any variable in either men or postmenopausal women.

CONCLUSIONS

Serum osteocalcin is associated with glucose and total adiponectin levels, fat mass, and atherosclerosis parameters in patients with type 2 diabetes, suggesting that osteocalcin is important for not only bone metabolism but also glucose and fat metabolism.

摘要

背景

近期的动物研究表明,骨钙素的作用不仅与骨代谢有关,还与糖代谢和脂肪量有关。我们研究了血清骨钙素和骨特异性碱性磷酸酶这两种骨形成标志物与2型糖尿病男性和绝经后女性的糖代谢、血清脂联素、脂肪量以及动脉粥样硬化参数之间的关系。

方法

连续招募了179名男性和149名绝经后女性,并收集了影像学和生化特征。评估肱踝脉搏波速度(baPWV)和内膜中层厚度(IMT)作为动脉粥样硬化的参数。

结果

在对年龄、糖尿病病程、体重指数和血清肌酐进行校正的多元回归分析中,骨钙素在男性和绝经后女性中均与空腹血糖和糖化血红蛋白A1c呈负相关(P<0.05),在男性中与脂肪百分比、baPWV和IMT呈负相关(P<0.05)。骨钙素在绝经后女性中与总脂联素呈正相关(P<0.001)。在进一步调整收缩压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、糖化血红蛋白A1c和布林克曼指数后,骨钙素在男性中仍与baPWV和IMT显著负相关。相比之下,骨钙素与空腹C肽无相关性,骨特异性碱性磷酸酶在男性或绝经后女性中与任何变量均无相关性。

结论

血清骨钙素与2型糖尿病患者的血糖、总脂联素水平、脂肪量和动脉粥样硬化参数相关,提示骨钙素不仅对骨代谢重要,对糖代谢和脂肪代谢也很重要。

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