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中国中老年男性血清骨钙素水平与糖代谢及颈动脉粥样硬化的关系:上海长风研究

Serum levels of osteocalcin in relation to glucose metabolism and carotid atherosclerosis in Chinese middle-aged and elderly male adults: the Shanghai Changfeng Study.

作者信息

Ma Hui, Lin Huandong, Hu Yu, Li Xiaoming, He Wanyuan, Jin Xuejuan, Gao Jian, Zhao Naiqing, Gao Xin

机构信息

Department of Endocrinology and Metabolism, Zhong Shan Hospital, Fudan University, Shanghai, China; Department of Geriatrics, Zhong Shan Hospital, Fudan University, Shanghai, China.

Department of Endocrinology and Metabolism, Zhong Shan Hospital, Fudan University, Shanghai, China.

出版信息

Eur J Intern Med. 2014 Mar;25(3):259-64. doi: 10.1016/j.ejim.2014.01.017. Epub 2014 Feb 9.

Abstract

BACKGROUND

The role of osteocalcin (OCN) in atherogenesis is unclear. We investigated the association between OCN and carotid atherosclerosis in Chinese middle-aged and elderly male adults and further determined whether OCN is independently associated with the carotid atherosclerosis in euglycemic subgroup.

METHODS

A total of 1077 male participants (mean age, 61.3 years) were enrolled from the Changfeng Study. A total of 638 subjects with normal glucose tolerance (NGT) were included in the subgroup analysis. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral carotid intima-media thicknesses (CIMTs) were measured using ultrasonography, and the presence of carotid plaques was assessed. The circulating OCN was measured using electrochemiluminescence immunoassay.

RESULTS

OCN was 18.5 ± 7.5 ng/ml in this male population. Both impaired glucose regulation (IGR) and new diagnosed diabetes (NDD) groups had significantly lower OCN levels compared with the NGT group (17.7 ± 0.4 ng/ml, and 17.4 ± 0.6 ng/ml vs 19.2 ± 0.3 ng/ml, respectively). Multivariate linear stepwise regression analysis demonstrated that triglyceride (TG) (standardized β=-0.065, p=0.042) and fasting blood glucose (FBG) (standardized β=-0.063, p=0.034) were independently and inversely associated with serum OCN. In the NGT subgroup analysis, compared with subjects with OCN in the first quartile, subjects with OCN in the fourth quartile had decreased prevalence of carotid plaque. After adjusting for conventional CVD risk factors, male participants with OCN in the fourth quartile had a 0.57-fold decreased risk of carotid plaques relative to those in the lowest quartile.

CONCLUSION

These results suggest that OCN is independently associated with carotid atherosclerosis in male individuals with NGT and that OCN may be implicated in not only glucose metabolism but also atherosclerosis.

摘要

背景

骨钙素(OCN)在动脉粥样硬化发生中的作用尚不清楚。我们调查了中国中老年男性成年人中OCN与颈动脉粥样硬化之间的关联,并进一步确定在血糖正常亚组中OCN是否与颈动脉粥样硬化独立相关。

方法

从长风研究中纳入了1077名男性参与者(平均年龄61.3岁)。亚组分析纳入了638名糖耐量正常(NGT)的受试者。对每位参与者进行了标准访谈、人体测量和实验室分析。使用超声测量双侧颈动脉内膜中层厚度(CIMT),并评估颈动脉斑块的存在情况。使用电化学发光免疫分析法测量循环OCN。

结果

该男性人群中OCN为18.5±7.5 ng/ml。与NGT组(分别为17.7±0.4 ng/ml和17.4±0.6 ng/ml,对比19.2±0.3 ng/ml)相比,糖调节受损(IGR)组和新诊断糖尿病(NDD)组的OCN水平均显著降低。多变量线性逐步回归分析表明,甘油三酯(TG)(标准化β=-0.065,p=0.042)和空腹血糖(FBG)(标准化β=-0.063,p=0.034)与血清OCN独立且呈负相关。在NGT亚组分析中,与OCN处于第一四分位数的受试者相比,OCN处于第四四分位数的受试者颈动脉斑块患病率降低。在调整传统心血管疾病危险因素后,OCN处于第四四分位数的男性参与者相对于最低四分位数的参与者,颈动脉斑块风险降低了0.57倍。

结论

这些结果表明,OCN与NGT男性个体的颈动脉粥样硬化独立相关,并且OCN可能不仅与糖代谢有关,还与动脉粥样硬化有关。

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