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2型糖尿病患者血清脂联素水平与骨密度、骨代谢标志物及椎体骨折之间的关系

Relationships between serum adiponectin levels versus bone mineral density, bone metabolic markers, and vertebral fractures in type 2 diabetes mellitus.

作者信息

Kanazawa Ippei, Yamaguchi Toru, Yamamoto Masahiro, Yamauchi Mika, 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

Eur J Endocrinol. 2009 Feb;160(2):265-73. doi: 10.1530/EJE-08-0642. Epub 2008 Nov 7.

Abstract

BACKGROUND

Although, adiponectin might be associated with bone metabolism, the relationships between serum adiponectin and bone mineral density (BMD) as well as vertebral fracture in type 2 diabetes are still unclear.

OBJECTIVE AND METHODS

We investigated the relationships between each of serum total and high molecular weight (HMW) adiponectin versus BMD, bone markers, and the presence of vertebral fractures in a total of 231 men and 170 post-menopausal women with type 2 diabetes.

RESULTS

Multiple regression analysis adjusted for age, duration of diabetes, BMI, serum creatinine, and HbA(1c) showed that serum total adiponectin was negatively correlated with BMD at the total, lumbar spine, and femoral neck (r=-0.165, P<0.05; r=-0.187, P<0.05; and r=-0.136, P<0.05 respectively) and positively with urinary N-terminal cross-linked telopeptide of type-I collagen in men (r=0.148, P<0.05), and that serum HMW adiponectin was negatively correlated with BMD at the lumbar spine (r=-0.146, P<0.05). Multivariate logistic regression analysis adjusted for the parameters described above showed that total adiponectin was associated with the presence of vertebral fractures in men (odds ratio (OR)=1.396, 95% confidential interval (CI) 1.020-1.911 per s.d. increase, P<0.05), and both total and HMW adiponectin were associated with moderate or severe vertebral fractures (OR=1.709, 95% CI 1.048-2.787 per s.d. increase, P<0.05 and OR=1.810, 95% CI 1.112-2.946 per s.d. increase, P<0.05 respectively), but not in post-menopausal women.

CONCLUSIONS

Serum adiponectin could be associated with BMD and turnover and clinically useful for assessing the risk of vertebral fractures in type 2 diabetic men.

摘要

背景

尽管脂联素可能与骨代谢有关,但2型糖尿病患者血清脂联素与骨密度(BMD)以及椎体骨折之间的关系仍不明确。

目的与方法

我们调查了231名男性和170名绝经后2型糖尿病女性的血清总脂联素和高分子量(HMW)脂联素与骨密度、骨标志物以及椎体骨折情况之间的关系。

结果

经年龄、糖尿病病程、体重指数、血清肌酐和糖化血红蛋白(HbA₁c)校正的多元回归分析显示,血清总脂联素与全身、腰椎和股骨颈的骨密度呈负相关(r = -0.165,P < 0.05;r = -0.187,P < 0.05;r = -0.136,P < 0.05),在男性中与Ⅰ型胶原的尿N端交联肽呈正相关(r = 0.148,P < 0.05),血清HMW脂联素与腰椎骨密度呈负相关(r = -0.146,P < 0.05)。经上述参数校正的多因素logistic回归分析显示,总脂联素与男性椎体骨折的发生有关(优势比(OR)= 1.396,每标准差增加95%置信区间(CI)1.020 - 1.911,P < 0.05),总脂联素和HMW脂联素均与中度或重度椎体骨折有关(OR = 1.709,每标准差增加95% CI 1.048 - 2.787,P < 0.05;OR = 1.810,每标准差增加95% CI 1.112 - 2.946,P < 0.05),但在绝经后女性中并非如此。

结论

血清脂联素可能与骨密度和骨转换有关,对评估2型糖尿病男性椎体骨折风险具有临床意义。

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