Department of Endocrine and Metabolic Diseases, The Persian Gulf Tropical Medicine Research Centre, Bushehr University of Medical Sciences, Bushehr, Islamic Republic of Iran.
J Bone Miner Metab. 2012 Nov;30(6):683-91. doi: 10.1007/s00774-012-0367-z. Epub 2012 Jul 3.
Although it has been shown that osteocalcin functions as a hormone in the regulation of glucose metabolism and fat mass, no population-based study to date has addressed serum osteocalcin levels in relation to energy metabolism concurrent with bone metabolism in postmenopausal women. In a population-based study, cardiovascular risk factors, high-sensitivity C-reactive protein (hs-CRP), osteoprotegerin, receptor activator of nuclear factor-κB ligand, osteocalcin, CrossLaps, alkaline phosphatase, and bone mineral density (BMD) at the lumbar spine (L2-L4) and the proximal femur were measured in 382 Iranian postmenopausal women. In multiple logistic regression analysis, lower osteocalcin and CrossLaps levels were associated with a higher odds ratio (OR) of having type 2 diabetes mellitus when adjustments were made for age, hs-CRP, cardiovascular risk factors, BMD, and markers of bone metabolism [OR 5.17, CI (2.66-10.04), p < 0.0001 and OR 2.51, CI (1.37-4.61), p = 0.003, respectively]. However, lower alkaline phosphatase levels were associated with a lower OR of having type 2 diabetes mellitus [OR 0.28, CI (0.15-0.52), p < 0.0001] in regression analysis. No significant difference was found between serum osteocalcin levels of those with and without metabolic syndrome. Among the metabolic syndrome components, low osteocalcin levels had significant associations with elevated blood glucose [OR 1.89, CI (1.16-3.07), p = 0.010] and elevated waist circumference [OR 2.53, CI (1.13-5.67), p = 0.024] in multivariate analyses. In conclusion, serum osteocalcin was independently associated with glucose intolerance and abdominal obesity as the components of metabolic syndrome and type 2 diabetes mellitus in postmenopausal women. Since CrossLaps and alkaline phosphatase levels were independently associated with the presence of type 2 diabetes mellitus, the unique contribution of osteocalcin in glucose metabolism could not be concluded.
尽管已经表明骨钙素在调节葡萄糖代谢和脂肪量方面发挥着激素的作用，但迄今为止，没有基于人群的研究针对绝经后妇女的骨代谢与能量代谢同时涉及的血清骨钙素水平。在一项基于人群的研究中，在 382 名伊朗绝经后妇女中测量了心血管危险因素、高敏 C 反应蛋白（hs-CRP）、护骨素、核因子-κB 配体受体激活剂、骨钙素、CrossLaps、碱性磷酸酶和腰椎（L2-L4）及股骨近端的骨密度（BMD）。在多变量逻辑回归分析中，当调整年龄、hs-CRP、心血管危险因素、BMD 和骨代谢标志物后，较低的骨钙素和 CrossLaps 水平与 2 型糖尿病的更高比值比（OR）相关[OR 5.17，CI（2.66-10.04），p<0.0001 和 OR 2.51，CI（1.37-4.61），p=0.003]。然而，较低的碱性磷酸酶水平与 2 型糖尿病的较低比值比相关[OR 0.28，CI（0.15-0.52），p<0.0001]。在回归分析中，未发现代谢综合征患者与无代谢综合征患者之间的血清骨钙素水平存在差异。在代谢综合征成分中，低骨钙素水平与血糖升高显著相关[OR 1.89，CI（1.16-3.07），p=0.010]和腰围升高显著相关[OR 2.53，CI（1.13-5.67），p=0.024]。总之，血清骨钙素与绝经后妇女的葡萄糖耐量和腹型肥胖（代谢综合征的组成部分）和 2 型糖尿病独立相关。由于 CrossLaps 和碱性磷酸酶水平与 2 型糖尿病的存在独立相关，因此不能得出骨钙素在葡萄糖代谢中具有独特贡献的结论。
