中国人群骨转换标志物与糖代谢的相关性研究。
Association of bone turnover markers with glucose metabolism in Chinese population.
机构信息
Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Department of Osteoporosis, Metabolic Bone Disease and Genetic Research Unit, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
出版信息
Acta Pharmacol Sin. 2017 Dec;38(12):1611-1617. doi: 10.1038/aps.2017.23. Epub 2017 Jul 27.
The association between type 2 diabetes (T2DM) and bone metabolism has been discussed previously but is controversial. In this study we aimed to evaluate the association of bone turnover markers with glucose metabolism in Chinese population, in which 919 males and 4171 postmenopausal females in a region of Shanghai were recruited. Anthropometric and biochemical traits related to glucose and bone metabolism were analyzed. Participants were classified according to their glucose tolerance as normal glucose tolerance (NGT), impaired glucose regulation (IGR) or T2DM. Males and females were analyzed separately, and then associations between bone turnover markers (BTMs) and glucose metabolism were evaluated. The results showed that in females, the serum levels of N-terminal osteocalcin (N-MID), N-terminal procollagen of type I collagen (PINP) and β-cross-linked C-telopeptide of type I collagen (β-CTX) were significantly decreased in the T2DM group compared to the NGT group (P<0.01). When age, body mass index, serum lipids, fat percentage, visceral fat area, subcutaneous fat area, anti-diabetic medicines, PINP, N-MID and β-CTX were included in one logistic model, N-MID (OR [95% CI]: 0.954 [0.932; 0.976]; P=0.0001) was significantly associated with T2DM in females. In females, N-MID was associated with insulin sensitivity and HOMA-β. PINP was significantly associated with HOMA-β, GUTT-ISI, Stumvoll first-phase insulin secretion index (STU-1) and Stumvoll second-phase insulin secretion index (STU-2), but β-CTX was associated only with HOMA-β (β±SE: 0.1331±0.0311; P=1.95×10) and GUTT-ISI (β±SE: 0.0727±0.0229; P=0.0015). In males, N-MID was significantly correlated with HOMA-β (β±SE: 0.3439±0.0633; P=7.75×10), GUTT-ISI (β±SE: 0.1601±0.0531; P=0.0027) and STU-1 (β±SE: 0.2529±0.1033; P=0.0146). Significant associations were also detected between β-CTX and HOMA-β (β±SE: 0.2736±0.0812; P=0.0009). This study reveals that BTMs are highly associated with T2DM, insulin sensitivity and beta cell function in both Chinese males and postmenopausal females.
2 型糖尿病（T2DM）与骨代谢之间的关联此前已有讨论，但存在争议。本研究旨在评估中国人群中骨转换标志物与葡萄糖代谢之间的关联，在上海的一个地区共招募了 919 名男性和 4171 名绝经后女性。分析了与葡萄糖和骨代谢相关的人体测量学和生化特征。根据葡萄糖耐量将参与者分为正常糖耐量（NGT）、糖调节受损（IGR）或 T2DM。分别对男性和女性进行分析，然后评估骨转换标志物（BTMs）与葡萄糖代谢之间的关系。结果显示，与 NGT 组相比，女性 T2DM 组血清 N 端骨钙素（N-MID）、I 型胶原 N 端前肽（PINP）和 I 型胶原β-交联 C 端肽（β-CTX）的水平显著降低（P<0.01）。当将年龄、体重指数、血清脂质、脂肪百分比、内脏脂肪面积、皮下脂肪面积、降糖药、PINP、N-MID 和 β-CTX 纳入一个逻辑模型时，N-MID（OR[95%CI]：0.954[0.932；0.976]；P=0.0001）与女性 T2DM 显著相关。在女性中，N-MID 与胰岛素敏感性和 HOMA-β 相关。PINP 与 HOMA-β、GUTT-ISI、Stumvoll 第一时相胰岛素分泌指数（STU-1）和 Stumvoll 第二时相胰岛素分泌指数（STU-2）显著相关，但 β-CTX 仅与 HOMA-β（β±SE：0.1331±0.0311；P=1.95×10）和 GUTT-ISI（β±SE：0.0727±0.0229；P=0.0015）相关。在男性中，N-MID 与 HOMA-β（β±SE：0.3439±0.0633；P=7.75×10）、GUTT-ISI（β±SE：0.1601±0.0531；P=0.0027）和 STU-1（β±SE：0.2529±0.1033；P=0.0146）显著相关。β-CTX 与 HOMA-β（β±SE：0.2736±0.0812；P=0.0009）之间也存在显著关联。本研究表明，BTMs 与中国男性和绝经后女性的 T2DM、胰岛素敏感性和胰岛β细胞功能密切相关。
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